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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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.
The following statements regarding retinoblastoma are correct:
- A. It is usually fatal even if diagnosis is made early
- B. The tumour is heritable
- C. They may occur bilaterally
- D. The finding of leucorrhoea suggests the diagnosis
Correct Answer: B
Rationale: Retinoblastoma is heritable and can occur bilaterally. Early diagnosis improves prognosis, and leucorrhoea is not associated with retinoblastoma.
A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow?
- A. Atrial septal defect
- B. Tetralogy of Fallot
- C. Ventricular septal defect
- D. Patent ductus arteriosus
Correct Answer: B
Rationale: Tetralogy of Fallot results in decreased blood flow to the lungs. The pulmonic stenosis increases the pressure in the right ventricle, causing the blood to go from right to left across the ventricular septal defect. Atrial and ventricular septal defects and patent ductus arteriosus result in increased pulmonary blood flow.
Decreased DLCO is seen with:
- A. Increased CO in circulation
- B. Anaemia
- C. Pulmonary fibrosis
- D. Exercise
Correct Answer: C
Rationale: Pulmonary fibrosis: Decreased diffusing capacity for carbon monoxide (DLCO) is a hallmark of pulmonary fibrosis, where lung tissue becomes scarred, reducing its ability to transfer gases.
Hypertrophic obstructive cardiomyopathy
- A. Causes LV outflow tract obstruction
- B. Occurs after adenoviral infection
- C. Commonly occurs in infancy
- D. Double apical impulse
Correct Answer: A
Rationale: Hypertrophic obstructive cardiomyopathy primarily causes left ventricular outflow tract obstruction.