The differential diagnosis of the patient includes all of the following EXCEPT
- A. rheumatic fever
- B. SLE
- C. chronic atrial fibrillation
- D. postmeningococcal immune complexes
Correct Answer: C
Rationale: Chronic atrial fibrillation is unlikely in an 8-year-old with acute onset symptoms.
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The most likely diagnosis in the patient described is
- A. persistent pulmonary hypertension
- B. transposition of the great arteries
- C. truncus arteriosus
- D. pulmonary atresia
Correct Answer: B
Rationale: Transposition of the great arteries often presents with cyanosis due to mixing of oxygenated and deoxygenated blood.
A woman who works as a data entry clerk is concerned as to how recent diagnosis of Raynaud's syndrome is going to affect her job performance. Which instruction should the nurse provide this client?
- A. Use a space heater to keep the workspace warm
- B. Keep hands elevated above the heart to prevent swelling.
- C. Wear tight gloves during work to avoid temperature fluctuations.
- D. Take frequent breaks to improve circulation in the hands.
Correct Answer: A
Rationale: Keeping the hands warm helps prevent vasospasms, which are characteristic of Raynaud's syndrome.
A male client is recovering from an episode of urinary tract calculi. During discharge teaching, the client asks about the dietary restriction he should follow. In discussing fluid intake, the nurse should include which type of fluid limitation?
- A. Low-sodium soups.
- B. Over all fluid intake
- C. Tea and hot chocolate
- D. Citrus fruit juices
Correct Answer: C
Rationale: Tea and hot chocolate contain oxalates, which can contribute to the formation of calcium oxalate stones. Limiting these fluids helps prevent recurrence.
All are true about TAPSE (Tricuspid Annular Plane Systolic Excursion), except
- A. Normal TAPSE is >17 mm
- B. Reliable measure of RV systolic function
- C. Can be measured using either M-mode or 2D echo
- D. TAPSE is measured at septal aspect of tricuspid annulus
Correct Answer: D
Rationale: TAPSE is measured at the lateral aspect of the tricuspid annulus, not the septal aspect.
Recognised diagnoses of tender scrotal swelling in infancy include:
- A. Inguinal hernia
- B. Epididymo-orchitis
- C. Breech delivery
- D. Torsion of testis
Correct Answer: D
Rationale: Torsion of the testis is a medical emergency and a common cause of tender scrotal swelling in infancy. Inguinal hernia and epididymo-orchitis are also possible but less urgent. Breech delivery is unrelated.