Nokea
The most likely diagnosis in the patient is
- A. patent ductus arteriosus
- B. critical aortic stenosis
- C. critical pulmonic stenosis
- D. tetralogy of Fallot
Correct Answer: D
Rationale: Tetralogy of Fallot involves right ventricular hypertrophy, a VSD, overriding aorta, and pulmonary stenosis, consistent with the findings.
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The nurse is caring for an 8-year-old girl whose parents indicate she has developed spastic movements of her extremities and trunk, facial grimace, and speech disturbances. They state it seems worse when she is anxious and does not occur while sleeping. The nurse questions the parents about which recent illness?
- A. Kawasaki disease (KD)
- B. Strep throat
- C. Malignant hypertension
- D. Atrial fibrillation
Correct Answer: B
Rationale: Chorea (spastic movements, facial grimacing, and speech disturbances) can be a manifestation of rheumatic fever following streptococcal pharyngitis, with a higher incidence in females.
Which among the following is not an admixture lesion?
- A. Transposition of great arteries
- B. Truncus arteriosus
- C. Total anomalous pulmonary venous connection
- D. Pulmonary atresia with intact ventricular septum
Correct Answer: D
Rationale: Pulmonary atresia with intact ventricular septum is not an admixture lesion.
The following are causes of congestive heart failure and cardiomegaly during the newborn period but no murmur EXCEPT
- A. endocardial fibroelastosis
- B. asphyxia
- C. glycogen storage disease (Pompe disease)
- D. sepsis
Correct Answer: D
Rationale: Sepsis can cause heart failure and cardiomegaly but often presents with other systemic signs.
A client uses triamcinolone (Kenalog), a corticosteroid ointment, to manage pruritus caused by a chronic skin rash. The client calls the clinic nurse to report increased erythema with purulent exudate at the site. Which action should the nurse implement?
- A. Schedule an appointment for the client to see the healthcare provider
- B. Advise the client to apply more corticosteroid cream
- C. Recommend using an antibiotic ointment.
- D. Instruct the client to stop using the medication for 24 hours.
Correct Answer: A
Rationale: Increased erythema and purulent exudate suggest infection. The client needs evaluation and possible treatment with antibiotics.
Proteins found in muscle fibers include:
- A. Vimentin
- B. Saccharin
- C. Keratin
- D. Desmin
Correct Answer: D
Rationale: Desmin: Desmin is an intermediate filament protein found in muscle cells, providing structural support and maintaining the integrity of muscle fibers.