Severe pulmonary valve stenosis is defined as a peak gradient of
- A. >40 mm Hg
- B. >45 mm Hg
- C. >50 mm Hg
- D. >55 mm Hg
Correct Answer: C
Rationale: Severe pulmonary valve stenosis is generally defined as a peak gradient >50 mm Hg.
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In urgent situations of supraventricular tachycardia (SVT) when symptoms of severe heart failure have already occurred, the initial management is
- A. adenosine by rapid intravenous push
- B. DC cardioversion
- C. verapamil
- D. digoxin
Correct Answer: B
Rationale: DC cardioversion is the preferred initial management in hemodynamically unstable SVT.
An emergency department nurse triages clients who present with chest discomfort. Which client should the nurse plan to assess first?
- A. A 42-year-old female who describes her pain as a dull ache with numbness in her fingers
- B. A 49-year-old male reports moderate pain that is worse on inspiration
- C. A 53-year-old female reports substernal pain that radiates to her abdomen
- D. A 58-year-old male describes his pain as an intense stabbing that spreads across his chest
Correct Answer: D
Rationale: Intense stabbing chest pain that spreads across the chest is highly suggestive of an acute cardiac event, such as a myocardial infarction, and requires immediate assessment.
In the electrocardiogram of a 40-year old male, the QRS amplitude in lead I and aVF measured (+) 10 and (-)10mV respectively. The frontal QRS axis is
- A. (+) 15°
- B. (-) 45°
- C. (-) 75°
- D. (-) 90°
Correct Answer: B
Rationale: The frontal QRS axis is (-) 45° given the QRS amplitudes in leads I and aVF.
Nystagmus can be a presenting sign in:
- A. Partial albinism
- B. Retinopathy of prematurity
- C. Acute vestibulitis
- D. Medulloblastoma
Correct Answer: D
Rationale: Medulloblastoma, a type of brain tumor, can present with nystagmus due to its impact on the cerebellum and brainstem.
Insulin-like growth factor-l (IGF-I):
- A. Increases during pubertal growth spurt
- B. Is a single polypeptide chain
- C. Is produced in pancreas
- D. Is secreted in a pulsatile manner
Correct Answer: A
Rationale: IGF-I levels rise significantly during the pubertal growth spurt, contributing to rapid growth and development.