Nokea
The jugular venous pressure (JVP) has a predictable relationship with pulmonary artery wedge pressure (PAWP). A JVP of >12 mm Hg predicted PAWP >22 mm Hg by 88% in which of the following trials?
- A. BNP
- B. ESCAPE
- C. EVEREST
- D. EMPA REG
Correct Answer: B
Rationale: The ESCAPE trial studied the effectiveness of therapies in patients with advanced heart failure and showed that elevated JVP was correlated with high pulmonary artery wedge pressures.
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The primary care pediatric nurse practitioner is performing a sports physical on an adolescent whose history reveals mild aortic stenosis (AS). What will the nurse practitioner recommend?
- A. Avoidance of all sports to prevent sudden death
- B. Clearance for any sports since this is mild
- C. Evaluation by a cardiologist prior to participation
- D. Low-intensity sports
Correct Answer: C
Rationale: Children with mild AS may participate in any sport but must have annual cardiac evaluations.
Ten hours following thrombolysis for an ST elevation myocardial infarction (STEMI), a client is receiving a lidocaine infusion for isolated runs of ventricular tachycardia (VT). Which finding should the nurse document in the electronic medical record as a therapeutic response to the lidocaine infusion?
- A. Stabilization of blood pressure ranges
- B. Cessation of chest pain
- C. Reduce heart rate
- D. Decreased frequency of episodes of VT
Correct Answer: D
Rationale: Lidocaine is used to suppress ventricular tachycardia, so a decrease in episodes indicates a therapeutic response.
A male client with muscular dystrophy fell in his home and is admitted with a right hip fracture. His right foot is cool, with palpable pedal pulses. Lungs are coarse with diminished bibasilar breath sounds. Vital signs are temperature 101F, heart rate 128 beats/minute, respirations 28 breaths/minute, and blood pressure 122/82. Which intervention is most important for the nurse to implement first?
- A. Obtain oxygen saturation level
- B. Encourage incentive spirometry
- C. Assess lower extremity circulation
- D. Administer PRN oral antipyretic
Correct Answer: D
Rationale: Administering an antipyretic addresses the fever, which is a priority in this client to prevent further complications.
A seizure episode may be mimicked by:
- A. Breath-holding episode
- B. Choreoathetosis
- C. Hysterical reactions
- D. Vasovagal attack
Correct Answer: A
Rationale: Breath-holding episodes in children can mimic seizures due to transient loss of consciousness, often triggered by emotional stress or pain.
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.