A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever?
- A. Subcutaneous nodules and fever
- B. Painful, tender joints, and carditis
- C. Erythema marginatum and arthralgia
- D. Chorea and elevated sedimentation rate
Correct Answer: B
Rationale: The presence of two major Jones criteria would indicate a high probability of rheumatic fever.
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At birth, tunica intima of arterial wall contains all of the following, except
- A. Type IV collagen
- B. Laminin
- C. Endothelial cells
- D. Smooth muscle cells
Correct Answer: D
Rationale: Smooth muscle cells are not typically found in the tunica intima at birth.
A young female client with seven children is having frequent morning headaches, dizziness, and blurred vision. Her blood pressure (BP) is 168/104 mmHg. The client reports that her husband recently lost his job and she is not sleeping well. After administering a STAT dose of an antihypertensive IV medication, which intervention is most important for the nurse to implement?
- A. Measure urine output hourly to assess for rental perfusion
- B. Request a prescription for pain medication
- C. Use an automated BP machine to monitor for hypotension
- D. Provide a quiet environment with low lighting
Correct Answer: C
Rationale: Monitoring blood pressure is crucial after administering an antihypertensive to ensure the client does not become hypotensive.
Features of severe folate deficiency include:
- A. Steatorrhoea
- B. Glossitis
- C. Leucoerythroblastic picture
- D. Increased total iron binding capacity
Correct Answer: B
Rationale: Glossitis, or inflammation of the tongue, is a common feature of folate deficiency due to its role in cell division and growth.
When explaining dietary guidelines to a client with acute glomerulonephritis (AGN), which instruction should the nurse include in the dietary teaching?
- A. Restrict sodium intake
- B. Encourage high-protein foods.
- C. Increase potassium intake.
- D. Decrease fluid intake.
Correct Answer: A
Rationale: Sodium restriction helps manage fluid retention and hypertension, which are common in AGN.
How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G?
- A. 1 year
- B. 2 years
- C. 5 years
- D. 10 years
Correct Answer: C
Rationale: Children who recover from rheumatic fever should have a chemoprophylaxis protocol of penicillin G injections (about 200,000 units per dose) for a minimum of 5 years or up to the age of 18 to prevent further bouts of rheumatic fever.
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