Nokea
Chief organ systems affected in acute graft-versus-host reaction are:
- A. Skin
- B. Renal system
- C. Gut
- D. CNS
Correct Answer: A
Rationale: The skin is one of the primary organ systems affected in acute graft-versus-host disease. The renal system, gut, and CNS can also be affected, but the skin is the most commonly involved.
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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.
A nurse cares for a client who is prescribed magnetic resonance imaging (MRI) of the heart. The client’s health history includes a previous myocardial infarction and pacemaker implantation. Which action should the nurse take?
- A. Schedule an electrocardiogram just before the MRI.
- B. Notify the healthcare provider before scheduling the MRI.
- C. Call the physician and request a laboratory draw for cardiac enzymes.
- D. Instruct the client to increase fluid intake the day before the MRI.
Correct Answer: B
Rationale: Clients with pacemakers are generally not candidates for MRI due to the risk of device malfunction or tissue damage. The healthcare provider must be notified to determine the best course of action.
Which of the following drugs have no mortality benefit?
- A. Nitrates
- B. Beta-blockers
- C. Trimetazidine
- D. RAAS blockers
Correct Answer: C
Rationale: Trimetazidine is used as an adjunct therapy in ischemic heart disease but does not have a proven mortality benefit, unlike RAAS blockers, beta-blockers, and nitrates.
What are FOUR absolute contraindications for cardiac transplantation?
- A. Active infection
- B. Ongoing malignancy
- C. Medical non-compliance
- D. Drug abuse
Correct Answer: D
Rationale: These are absolute contraindications for cardiac transplantation due to the risks of infection, poor outcomes, and non-compliance.
All the following antimalarials act by forming heme complexes which are toxic to the parasite except
- A. Primaquine
- B. Chloroquine
- C. Mefloquine
- D. Quinidine
Correct Answer: A
Rationale: Primaquine does not act by forming heme complexes; it works through a different mechanism.