Nokea
A child with rheumatic fever is being admitted to the pediatric floor. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever?
- A. “Has your child complained of back pain?â€
- B. “Has your child complained of headaches?â€
- C. “Has your child had any nausea or vomiting?â€
- D. “Did your child have a sore throat or fever within the last 2 months?â€
Correct Answer: D
Rationale: A history of sore throat or fever within the last 2 months is significant as rheumatic fever often follows a streptococcal infection such as strep throat.
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Respiratory distress at birth is mostly caused by:
- A. Diaphragmatic hernia
- B. Meconium aspiration
- C. RDS (respiratory distress syndrome)
- D. Pulmonary hypertension
Correct Answer: C
Rationale: The correct answer is C because RDS is the most common cause of respiratory distress in newborns. The other options (a, b, d, e) are less common causes.
Evidence of increased pulmonary flow is associated with:
- A. Coarctation of the aorta
- B. Fallot's tetralogy
- C. Pneumocystis infection
- D. Ventricular septal defect
Correct Answer: D
Rationale: A ventricular septal defect (VSD) leads to increased pulmonary blood flow due to left-to-right shunting, resulting in pulmonary congestion.
The radiographic finding of notching of the ribs is associated with
- A. pulmonary hypertension
- B. anomalous pulmonary venous return above the diaphragm
- C. coarctation of the aorta
- D. systemic hypertension
Correct Answer: C
Rationale: Rib notching is a classic radiographic sign of coarctation of the aorta due to collateral vessel development.
Common pathogens in the sputum of CF patients are:
- A. Pseudomonas
- B. Staphylococcus epidermidis
- C. Staphylococcus aureus
- D. Burkholderia
Correct Answer: A
Rationale: The correct answer is A because Pseudomonas is the most common pathogen in CF patients. The other options (b-e) are less common.
Afterload reducers are not indicated in children with heart failure secondary to
- A. cardiomyopathy
- B. severe mitral insufficiency
- C. aortic stenosis
- D. ventricular septal defect
Correct Answer: C
Rationale: Afterload reducers are contraindicated in conditions where forward flow is already compromised, such as aortic stenosis.