A client's telemetry monitor indicates ventricular fibrillation (VF). After delivering one counter shock, the nurse resumes chest compression. After another minute of compressions, the client's rhythm converts to supraventricular tachycardia (SVT) on the monitor. At this point, what is the priority intervention for the nurse?
- A. Prepare for transcutaneous pacing
- B. Deliver another defibrillator shock
- C. Administer IV Epinephrine per ACLS protocol
- D. Give IV dose of adenosine rapidly over 1-2 seconds
Correct Answer: D
Rationale: SVT can be treated by rapidly administering adenosine to restore normal sinus rhythm.
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The following statements regarding retinoblastoma are correct:
- A. It is usually fatal even if diagnosis is made early
- B. The tumour is heritable
- C. They may occur bilaterally
- D. The finding of leucorrhoea suggests the diagnosis
Correct Answer: B
Rationale: Retinoblastoma is heritable and can occur bilaterally. Early diagnosis improves prognosis, and leucorrhoea is not associated with retinoblastoma.
Triggers of the alternate pathway of complement are:
- A. Bacterial lipopolysaccharide
- B. Interleukin 2
- C. Macrophages
- D. Properdin
Correct Answer: A
Rationale: The correct answer is A because bacterial lipopolysaccharide is a known trigger of the alternate complement pathway. The other options (b-e) are not primary triggers.
All patients with clinical evidence of a PDA are at increased risk for endocarditis. As a result, patients with PDA should be considered for irreversible closure EXCEPT
- A. small, hemodynamically insignificant PDA
- B. small, hemodynamically significant PDA
- C. moderate PDA
- D. large PDA
Correct Answer: A
Rationale: Small, hemodynamically insignificant PDAs may not require closure.
Which painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?
- A. Osler nodes
- B. Janeway lesions
- C. Subcutaneous nodules
- D. Aschoff nodes
Correct Answer: A
Rationale: Osler nodes are red, painful, intradermal nodes found on pads of the phalanges in bacterial endocarditis. Janeway lesions are painless hemorrhagic areas on palms and soles in bacterial endocarditis. Subcutaneous odules are nontender swellings, located over bony prominences, commonly found in rheumatic fever. Aschoff nodules are small nodules composed of cells and leukocytes found in the interstitial tissues of the heart in rheumatic myocarditis
Patients at risk for bacterial endocarditis include those with all of the following EXCEPT
- A. repaired simple atrial septic defect
- B. aortic stenosis
- C. rheumatic fever heart disease
- D. palliative vascular shunts
Correct Answer: A
Rationale: Repaired simple atrial septal defects are not considered a risk for bacterial endocarditis unless there are residual defects.