Nokea
An 8-year-old female presents with chest pain of 1 day's duration. Five days prior to the pain, she had fever, chills, and myalgias. Physical examination reveals an uncomfortable, anxious, afebrile patient with tachycardia, no murmur, and distant heart sounds. The chest x-ray is shown in Figure 19-2. There is a paradoxical pulse of 22 mm Hg. The most likely diagnosis is
- A. myocarditis
- B. cardiomyopathy
- C. Kawasaki disease
- D. pericarditis
Correct Answer: D
Rationale: Pericarditis causes distant heart sounds, paradoxical pulse, and can follow viral illnesses.
You may also like to solve these questions
A female client who was involved in a motor vehicle collision with a fractured left femur which is immobilized using a fracture traction splint in preparation for an open reduction internal fixation (ORIF). The nurse determines that her distal pulses are diminished in the left foot. Which interventions should the nurse implement? Select all that apply.
- A. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure. Verify pedal pulses using a doppler pulse device. Evaluate the application of the splint to the left leg
- B. Verify pedal pulses using a Doppler pulse device
- C. Evaluate the application of the splint to the left leg.
- D. Administer pain medication to alleviate discomfort.
Correct Answer: A
Rationale: Monitoring for signs of compartment syndrome and verifying pulses are critical to ensure adequate circulation and prevent complications.
The family suspects that AIDS dementia is occurring in their son who is HIV positive. Which symptom confirms their suspicions?
- A. A change has recently occurred in his handwriting.
- B. The client has a persistent cough and fever.
- C. The client experiences shortness of breath.
- D. The client exhibits a loss of appetite.
Correct Answer: A
Rationale: Changes in handwriting may indicate cognitive decline, a hallmark of AIDS dementia.
Despite the use of antibiotic agents, mortality remains high, in the range of 20-25%. Serious morbidity occurs in 50-60% of children with documented infective endocarditis. Of the following, the MOST common morbidity is
- A. heart failure
- B. pulmonary emboli
- C. mycotic aneurysms
- D. acquired ventricular septal defect
Correct Answer: A
Rationale: Heart failure is the most common morbidity in children with infective endocarditis.
A male client tells the clinic nurse that he is experiencing burning on urination, and assessment reveals that he had sexual intercourse four days ago with a woman he casually met. Which action should the nurse implement?
- A. Observe the perineal area for a chancroid-like lesion
- B. Obtain a specimen of urethral drainage for culture
- C. Assess for perineal itching, erythema and excoriation
- D. Identify all sexual partners in the last four days
Correct Answer: B
Rationale: A culture of urethral drainage is necessary to diagnose a potential sexually transmitted infection (STI).
Mycoplasma pneumonia:
- A. Is associated with bullous myringitis
- B. Cold haemaglutinin antibodies are a recognised finding
- C. Guillain-Barre syndrome is a recognised sequel
- D. Is associated with erythema marginatum
Correct Answer: B
Rationale: Cold haemagglutinin antibodies are a recognized finding in Mycoplasma pneumonia. Bullous myringitis and Guillain-Barre syndrome are also associated.