Nokea
Regarding mitral valve prolapse, all the following are true EXCEPT
- A. it is predominantly in girls
- B. it is usually sporadic
- C. the dominant abnormal signs are auscultatory
- D. antibiotic prophylaxis is recommended during surgery and dental procedures
Correct Answer: D
Rationale: Antibiotic prophylaxis is no longer universally recommended for mitral valve prolapse.
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The following criteria are indications for further investigation of premature ventricular contractions (PVCs) that could require suppressive therapy EXCEPT
- A. multiform PVCs
- B. disappear during exercise
- C. R-on-T phenomenon
- D. extreme frequency of beats
Correct Answer: B
Rationale: PVCs that disappear during exercise are less concerning and do not necessarily require suppressive therapy.
Rocker bottom feet and polyvalvular dysplasia are characteristic of which of the following?
- A. Trisomy 19
- B. Trisomy 18
- C. Trisomy 13
- D. Trisomy 21
Correct Answer: B
Rationale: Rocker bottom feet and polyvalvular dysplasia are classic signs of trisomy 18 (Edwards syndrome), a condition that involves multiple congenital anomalies.
The parents of a young child with heart failure tell the nurse that they are “nervous†about giving digoxin (Lanoxin). The nurse’s response should be based on which statement?
- A. It is a safe, frequently used drug.
- B. It is difficult to either overmedicate or undermedicate with digoxin.
- C. Parents lack the expertise necessary to administer digoxin.
- D. Parents must learn specific, important guidelines for administration of digoxin.
Correct Answer: D
Rationale: Digoxin has a narrow therapeutic range. The margin of safety between therapeutic, toxic, and lethal doses is very small. Specific guidelines are available for parents to learn how to administer the drug safely and to monitor for side effects. Digoxin is a frequently used drug, but it has a narrow therapeutic range. Small amounts of the liquid are given to infants, making it easy to overmedicate or undermedicate. Parents may lack the necessary expertise to administer the drug at first, but with discharge preparation, they should be prepared to administer the drug safely.
Which is a major clinical manifestation of rheumatic fever?
- A. Polyarthritis
- B. Osler nodes
- C. Janeway spots
- D. Splinter hemorrhages of distal third of nails
Correct Answer: A
Rationale: Polyarthritis, which is swollen, hot, red, and painful joints, is a major clinical manifestation of rheumatic fever. The affected joints will change every 1 to 2 days. Primarily the large joints are affected. Osler nodes, Janeway spots, and splinter hemorrhages are characteristic of infective endocarditis.
A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals: HR: 220 beats per minute (regular) Respiratory rate: 30 per minute BP: 84/52 Capillary refill: 3 seconds Which dysrhythmia does the nurse suspect in this child?
- A. Rapid pulmonary flutter
- B. Sinus bradycardia
- C. Rapid atrial fibrillation
- D. Supraventricular tachycardia (SVT)
Correct Answer: D
Rationale: SVT is typically above 200 beats per minute and can result from dehydration; the rapid rate causes low cardiac output (CO), resulting in low BP and prolonged capillary refill.