Nokea
Left axis deviation of the QRS complex is associated with all the following except
- A. Inflow ventricular septal defect
- B. Pulmonary atresia with intact interventricular septum
- C. Double outlet right ventricle with subaortic ventricular septal defect
- D. Noonan syndrome with pulmonary stenosis
Correct Answer: A
Rationale: Left axis deviation is not typically associated with inflow ventricular septal defect.
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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.
Azathioprine:
- A. Is a prodrug
- B. Is teratogenic
- C. Should be avoided in liver disease
- D. Dose should be increased when given with allopurinol
Correct Answer: A
Rationale: Azathioprine is a prodrug. It is not highly teratogenic, can be used in liver disease with caution, and its dose should be reduced with allopurinol.
A client who has a history of hypothyroidism was initially admitted with lethargy and confusion. Which additional finding warrants the most immediate action by the nurse?
- A. Facial puffiness and periorbital edema
- B. Hematocrit of 30%
- C. Cold and dry skin
- D. Further decline in level of consciousness
Correct Answer: D
Rationale: A further decline in level of consciousness could indicate myxedema coma, a life-threatening complication of hypothyroidism.
The nurse is caring for a child with Kawasaki disease (KD). A student nurse asks if there are medications to treat this disease. The nurse's response is:
- A. Immunoglobulin G and aspirin
- B. Immunoglobulin G and ACE inhibitors
- C. Immunoglobulin E and heparin
- D. Immunoglobulin E and ibuprofen
Correct Answer: A
Rationale: High-dose IV immunoglobulin G along with high-dose aspirin (salicylate therapy) is the current treatment for KD.
The most common cardiac anomaly associated with Coarctation of aorta is
- A. Bicuspid aortic valve
- B. Subaortic ventricular septal defect
- C. Atrial septal defect
- D. Supramitral ring
Correct Answer: A
Rationale: Bicuspid aortic valve is the most common cardiac anomaly associated with coarctation of the aorta.