In 90% of cases of endocarditis, the causative agent is recovered from the first 2 blood cultures. Antimicrobial pretreatment of the patient reduces the yield of blood cultures to
- A. 10%
- B. 20%
- C. 30%
- D. 40%
Correct Answer: A
Rationale: Antimicrobial pretreatment can significantly reduce the yield of blood cultures, often to 10-20%.
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During a routine well child exam on a 5-year-old child, a grade II/VI, harsh, late systolic ejection murmur at the upper left sternal border that transmits to both lung fields is auscultated. The child has normal growth and development. What will the nurse practitioner suspect?
- A. Aortic stenosis (AS)
- B. Patent ductus arteriosus (PDA)
- C. Pulmonic stenosis
- D. Tricuspid atresia
Correct Answer: C
Rationale: Pulmonic stenosis may be asymptomatic with a murmur as described above.
The following conditions can present in a newborn infant as a bullous eruption:
- A. Syphilis
- B. Mast cell disease
- C. Epidermolysis bullosa
- D. Phenylketonuria
Correct Answer: C
Rationale: Epidermolysis bullosa is a genetic condition causing blistering of the skin. Syphilis and mast cell disease can also cause bullous eruptions, but phenylketonuria does not.
The ECG in left ventricular hypertrophy and shows a superior QRS axis (between -90' and 0')
- A. tricuspid atresia
- B. Ebstein anomaly
- C. pulmonary atresia
- D. tetralogy of Fallot
Correct Answer: D
Rationale: Left ventricular hypertrophy with a superior QRS axis is characteristic of tetralogy of Fallot.
A 10-year-old client contracted severe acute respiratory syndrome (SARS) when traveling abroad with her parents. The nurse knows she must put on personal protective equipment to protect herself while providing care. Based on the mode of SARS transmission, which personal protective should the nurse wear?
- A. Gloves
- B. Gown and gloves
- C. Gown, gloves, and mask
- D. Gown, gloves, mask, and eye goggles or eye shield
Correct Answer: D
Rationale: SARS is transmitted through droplets, so full protective gear, including eye protection, is necessary to prevent infection.
Common reasons for doing a BMT in children are:
- A. SCID (severe combined immunodeficiency)
- B. Acute lymphoblastic leukemia
- C. CML
- D. Gaucher's disease
Correct Answer: A
Rationale: The correct answer is A because SCID is a primary indication for bone marrow transplant (BMT) in children. The other options (b-e) are also indications but less common.