Nokea
A child has been diagnosed with valvular disease following rheumatic fever (RF). During patient teaching, the nurse discusses the child's long-term prophylactic therapy with antibiotics for dental procedures, surgery, and childbirth. The parents indicate they understand when they say:
- A. She will need to take the antibiotics until she is 18 years old.
- B. She will need to take the antibiotics for 5 years after the last attack.
- C. She will need to take the antibiotics for 10 years after the last attack.
- D. She will need to take the antibiotics for the rest of her life.
Correct Answer: D
Rationale: Valvular involvement indicates significant damage; therefore, lifelong prophylactic antibiotics are required.
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A diagnosis of primary pulmonary hypertension of the newborn can be made if:
- A. Oxygen saturation in the hand is 80% and in the foot 67%
- B. A tachypnoeic baby has a saturation of 60%
- C. A baby with history of being covered in thick meconium at birth has PaO2 of 4kPa
- D. A septic baby is hypoxic in 100% oxygen
Correct Answer: A
Rationale: A significant difference in oxygen saturation between the upper and lower extremities (e.g., hand 80%, foot 67%) is indicative of persistent pulmonary hypertension of the newborn (PPHN).
Clinical diagnostic clues in an adolescent female with chronic cough:
- A. Pale stools and diarrhoea
- B. Aspergillus precipitin positive
- C. Calcified bronchopulmonary lymph nodes
- D. Whooping cough in the past
Correct Answer: B
Rationale: Aspergillus precipitin positive: A positive Aspergillus precipitin test indicates Aspergillus exposure, which could lead to chronic pulmonary issues, especially in immunocompromised individuals.
What are FOUR possible causes of left axis deviation in a newborn with features of Trisomy 21?
- A. AVSD
- B. Tricuspid atresia
- C. Pulmonary atresia with intact ventricular septum
- D. Mechanical shift
Correct Answer: A
Rationale: AVSD is a common congenital heart defect associated with Trisomy 21 and can lead to left axis deviation seen on ECG.
Which physiological changes occur as a result of hypoxemia in congestive heart failure (CHF)?
- A. Polycythemia and clubbing
- B. Anemia and barrel chest
- C. Increased white blood cells and low platelets
- D. Elevated erythrocyte sedimentation rate and peripheral edema
Correct Answer: A
Rationale: Hypoxemia stimulates erythropoiesis, causing polycythemia, which along with chronic hypoxemia can lead to digital clubbing.
During a home visit, the nurse assesses the skin of a client with eczema who reports that an exacerbation of symptoms has occurred during the last week. Which information is most useful in determining the possible cause of the symptoms?
- A. An old friend with eczema came for a visit
- B. Recently received an influenza immunization
- C. A grandson and his new dog recently visited
- D. Corticosteroid cream was applied to eczema
Correct Answer: C
Rationale: Exposure to new allergens, such as a pet, can trigger eczema flare-ups.