Nokea
The nurse calculates the body mass index (BMI) for an obese adult. Which additional assessment finding places the client at high risk for cardiac disease?
- A. Large waist circumference with central fat
- B. High serum insulin level
- C. Hyperpigmentation on neck skin folds
- D. Poor muscle tone
Correct Answer: A
Rationale: A large waist circumference with central fat is associated with an increased risk for cardiac disease due to visceral fat accumulation.
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Methaemoglobinaemia may occur as a result of ingestion or exposure to:
- A. Paraquat
- B. Methylene blue
- C. Potassium permanganate
- D. Nitrates
Correct Answer: D
Rationale: Nitrates, when ingested, can lead to methaemoglobinaemia by converting hemoglobin to methemoglobin, impairing oxygen delivery.
Which is the leading cause of death after heart transplantation?
- A. Infection
- B. Rejection
- C. Cardiomyopathy
- D. Heart failure
Correct Answer: B
Rationale: The posttransplant course is complex. The leading cause of death after cardiac transplantation is rejection. Infection is a continued risk secondary to the immunosuppression necessary to prevent rejection. Cardiomyopathy is one of the indications for cardiac transplant. Heart failure is not a leading cause of death.
During a well-child checkup for an infant with tetralogy of Fallot (TOF), the child develops severe respiratory distress and becomes cyanotic. The nurse's first action should be to:
- A. Lay the child flat to promote hemostasis
- B. Lay the child flat with legs elevated to increase blood flow to the heart
- C. Sit the child on the parent's lap, with legs dangling, to promote venous pooling
- D. Hold the child in knee-chest position to decrease venous blood return
Correct Answer: D
Rationale: The knee-chest position increases systemic vascular resistance (SVR), which increases blood flow to the pulmonary artery.
What are FIVE non-cardiac clinical features of Marfan’s syndrome?
- A. Ectopia Lentis
- B. Pectus Excavatum or carinatum of moderate severity
- C. Pes Planus
- D. Scoliosis (>20 degrees)
Correct Answer: A
Rationale: These features are typical signs of Marfan’s syndrome and contribute to the diagnosis alongside cardiac findings.
Features of severe haemophilia A include:
- A. Retroperitoneal bleed
- B. Chronic arthropathy
- C. Prolonged bleeding time
- D. Increased APTT
Correct Answer: D
Rationale: Increased activated partial thromboplastin time (APTT) is a characteristic feature of haemophilia A due to the deficiency of clotting factor VIII.