The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, "Why do my child's fingertips look like that?" On what understanding does the nurse base a response?
Clubbing occurs as a result of decreased cardiac output.
Clubbing occurs as a result of a left-to-right shunting of blood.
Clubbing occurs as a result of chronic hypoxia
Clubbing occurs as a result of untreated congestive heart failure.
The Correct Answer is C
C. Clubbing, characterized by bulbous enlargement of the fingertips and nail bed, is a result of chronic hypoxia in tetralogy of Fallot. In tetralogy of Fallot, there is a right-to-left shunting of blood due to the presence of a ventricular septal defect, overriding aorta, pulmonary stenosis, and right ventricular hypertrophy. This leads to reduced oxygenation of blood and chronic hypoxia, which can result in clubbing of the fingertips over time.
A This option is not the primary explanation for clubbing in tetralogy of Fallot. While decreased cardiac output may contribute to some manifestations of the condition, clubbing specifically results from chronic hypoxia rather than decreased cardiac output alone.
B Clubbing is not directly caused by a left-to-right shunting of blood. Instead, it is associated with chronic hypoxia, which can occur due to right-to-left shunting of blood in tetralogy of Fallot.
D Congestive heart failure may occur in individuals with tetralogy of Fallot but it is not the primary cause of clubbing. Clubbing in tetralogy of Fallot is primarily attributed to chronic hypoxia rather than heart failure alone.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
- This aligns with general guidelines for managing bacterial conjunctivitis, which emphasize the importance of cleanliness and avoiding the sharing of personal items to contain the infection.
A. Bacterial conjunctivitis is highly contagious, and the child should not attend school until they have been on antibiotics for at least 24 hours and their symptoms are improving. Allowing the child to attend school before this time could lead to the spread of the infection to other children.
B. Crusted material around the eye should be gently wiped away using a clean cotton ball soaked in warm water. It's important to start wiping from the inner aspect of the eye and move toward the outer aspect to prevent spreading any infectious material into the eye.
D. Eye medications, especially antibiotics prescribed for bacterial conjunctivitis, should not be saved for future use or shared with others. Each individual should have their own prescribed medication to avoid the risk of improper dosing or spread of infection.
Correct Answer is D
Explanation
D. This is the correct characteristic of decerebrate posturing. Decerebrate posturing is characterized by rigid extension and pronation (turning inward) of the arms and legs. It indicates severe neurological dysfunction and increased intracranial pressure, often involving damage to the brainstem.
A. This characteristic is not associated with decerebrate posturing. Adduction refers to movement toward the midline of the body, which is not typically observed in decerebrate posturing.
B. This description is not characteristic of decerebrate posturing. Decerebrate posturing involves extension, not flexion, of the upper extremities, along with extension and pronation (not adduction) of the lower extremities.
C. Flaccid paralysis refers to the absence of muscle tone and movement, which is not characteristic of decerebrate posturing. Decerebrate posturing involves increased muscle tone and abnormal, rigid extension of the arms and legs.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today