Nokea
The clinic nurse is reviewing strategies for blood glucose monitoring with a client who is newly diagnosed with diabetes mellitus. When helping the client select a blood glucose meter, which client assessments should the nurse complete?
- A. Manual dexterity and visual acuity
- B. Capillary refill time and radial pulse volume
- C. Deep tendon reflexes and skin color
- D. Skin elasticity and hand grip strength
Correct Answer: A
Rationale: Manual dexterity and visual acuity are important for the client to properly use the glucose meter.
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ECG
- A. Bifid P waves in large VSD
- B. Complete Ht block in cyanotic attacks of fallots
- C. RBBB in Ebstein anomaly
- D. Right axis deviation in tricuspid atresia
Correct Answer: C
Rationale: In Ebstein's anomaly, right bundle branch block (RBBB) is commonly seen on ECG.
Which painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?
- A. Osler nodes
- B. Janeway lesions
- C. Subcutaneous nodules
- D. Aschoff nodes
Correct Answer: A
Rationale: Osler nodes are red, painful, intradermal nodes found on pads of the phalanges in bacterial endocarditis. Janeway lesions are painless hemorrhagic areas on palms and soles in bacterial endocarditis. Subcutaneous odules are nontender swellings, located over bony prominences, commonly found in rheumatic fever. Aschoff nodules are small nodules composed of cells and leukocytes found in the interstitial tissues of the heart in rheumatic myocarditis
What are FOUR typical cath findings consistent with biatrial enlargement?
- A. Prominent y-descent
- B. Square root sign
- C. RVSp >55mmHg
- D. RVEDp/RVSp <1/3
Correct Answer: A
Rationale: These cath findings are indicative of biatrial enlargement, typically observed in certain heart conditions affecting the atrial chambers.
The following statements concerning acute gastroenteritis in childhood are correct:
- A. Intravenous fluid therapy is essential in severe cases
- B. Loperamide should be avoided
- C. The commonest causes of failure to thrive following an attack is persistent bacterial infection
- D. Septicaemia is a recognised feature of Salmonella gastroenteritis
Correct Answer: A
Rationale: Intravenous fluid therapy is critical in severe dehydration due to gastroenteritis. Loperamide is contraindicated in children due to risk of serious side effects. Persistent bacterial infection is not the commonest cause of failure to thrive, and septicaemia is rare in Salmonella gastroenteritis.
A previously well 3½-month-old presents with poor feeding, diaphoresis during feeding, and poor growth. Vital signs reveal respirations of 70, pulse of 175, and blood pressure of 90/65 mm Hg in the upper and lower extremities. The cardiac examination reveals a palpable parasternal lift and a systolic thrill. A grade 4 holosystolic murmur and a mid-diastolic rumble are noted. The chest radiograph reveals cardiomegaly. The most likely diagnosis is
- A. cardiomyopathy
- B. myocarditis
- C. VSD
- D. coarctation of the aorta
Correct Answer: C
Rationale: The presentation suggests a large ventricular septal defect (VSD) causing significant left-to-right shunting and heart failure.