Nokea
The differential in a 5-year old with a 2-week history of painful joints is all the following except:
- A. Viral polyarthritis
- B. Rheumatoid arthritis
- C. Lyme disease
- D. Rheumatic fever
Correct Answer: B
Rationale: rheumatoid arthritis is rare in a 5-year-old with a 2-week history of joint pain. The other options (a-d) are more likely differentials.
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Which of the following has the highest proportion of etiology of congenital malformations?
- A. Maternal infections
- B. Maternal illness
- C. Environmental agents
- D. Monogenic inheritance
Correct Answer: D
Rationale: Monogenic inheritance accounts for the highest proportion of congenital malformations.
What does the nurse explain that a ventricular septal defect will allow?
- A. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
- B. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis
- C. No shunting because of high pressure in the left ventricle
- D. Increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume
Correct Answer: A
Rationale: Pulmonary blood flow is increased when a ventricular septal defect exists. The blood shifts from left to right because of the higher pressure in the left ventricle. This particular shift does not cause cyanosis.
Which of the following statements is true regarding alcohol septal ablation?
- A. Indicated when dynamic LV outflow gradient is more than 50 mm Hg at rest
- B. Targeted septal thickness less than 16 mm is a contraindication
- C. Usually preferred over surgical myomectomy
- D. Reduces risk of sudden death
Correct Answer: A
Rationale: Alcohol septal ablation is indicated when the dynamic LV outflow gradient is more than 50 mm Hg at rest.
A nurse assesses a client who is scheduled for a cardiac catheterization. Which assessment should the nurse complete before this procedure?
- A. Client’s level of anxiety
- B. Ability to turn self in bed
- C. Cardiac rhythm and heart rate
- D. Allergies to iodine-based agents
Correct Answer: D
Rationale: Assessing for allergies to iodine-based agents is critical before cardiac catheterization, as contrast dye used during the procedure may cause an allergic reaction.
Normal Heart
- A. Ventricular septal depolarization occurs from Lt ï‚® Rt
- B. During tachycardia diastolic time reduced than systolic time
Correct Answer: B
Rationale: During tachycardia, diastolic time is significantly reduced compared to systolic time.