Nokea
The nurse is caring for a child with acute glomerulonephritis. Which of the following would most likely indicate that the child’s condition is improving?
- A. Increased urine output with normal color and consistency
- B. Decrease in the blood pressure
- C. A reduction in protein levels in the urine
- D. A decrease in hematuria
Correct Answer: A
Rationale: Improved renal function is indicated by increased urine output and the return of urine to normal color and consistency.
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Duchenne muscular dystrophy:
- A. Has an association with malignant hyperpyrexia
- B. Is a reason for never running properly
- C. Is better diagnosed with muscle biopsy than gene probe
- D. Is associated with speech delay
Correct Answer: D
Rationale: Duchenne muscular dystrophy is associated with speech delay due to progressive muscle weakness, including facial muscles affecting speech.
Pulmonary hypertension is a complication of:
- A. ASD
- B. Eisenmenger syndrome
- C. Tricuspid atresia
- D. Tricuspid regurgitation
Correct Answer: B
Rationale: Eisenmenger syndrome is a well-known cause of pulmonary hypertension. The other options (a-d) can also lead to pulmonary hypertension but are less specific.
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.
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.
Defects of complement system should be suspected in:
- A. Recurrent folliculitis
- B. Facial swelling following trauma
- C. Recurrent meningococcal infection
- D. Pneumocystis carinii pneumonia
Correct Answer: C
Rationale: Recurrent meningococcal infection: Defects in the complement system, especially the terminal complement components, increase the risk of recurrent meningococcal infections.