Nokea
The nurse reviews the laboratory results for a child with a suspected diagnosis of rheumatic fever. The nurse knows that which laboratory study would assist in confirming the diagnosis?
- A. Immunoglobulin
- B. Red blood cell count
- C. White blood cell count
- D. Anti-streptolysin O titer
Correct Answer: D
Rationale: The Anti-streptolysin O titer is used to confirm a diagnosis of rheumatic fever as it indicates a recent streptococcal infection, which is a precursor to rheumatic fever.
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What are the four structural heart anomalies that make up the tetralogy of Fallot? (Select the four that apply.)
- A. Hypertrophied right ventricle
- B. Patent ductus arteriosus
- C. Ventral septal defect
- D. Narrowing of pulmonary artery
Correct Answer: D
Rationale: The four anomalies that comprise tetralogy of Fallot are hypertrophied right ventricle, patent ductus arteriosus, stenosis of pulmonary artery, and dextroposition of the aorta.
The MOST common cause of sudden death in competitive athletes is
- A. aortic stenosis
- B. hypertrophic cardiomyopathy
- C. coronary artery abnormalities
- D. myocarditis
Correct Answer: B
Rationale: Hypertrophic cardiomyopathy is the leading cause of sudden death in competitive athletes.
A client with hypothyroidism reports difficulty falling asleep because of feelings of depression. Which action should the nurse implement?
- A. Review most recent thyroid function test results
- B. Encourage the client to take an afternoon nap.
- C. Refer the client for a psychiatric evaluation.
- D. Suggest reducing fluid intake before bedtime.
Correct Answer: A
Rationale: Hypothyroidism can cause depression and sleep disturbances. Reviewing thyroid function tests helps determine if the symptoms are related to inadequate thyroid hormone levels.
A 9-month-old infant has a grade III/VI, harsh, rumbling, continuous murmur in the left infraclavicular fossa and pulmonic area. A chest radiograph reveals cardiac enlargement. The primary care pediatric nurse practitioner will refer the infant to a pediatric cardiologist and prepare the parents for which intervention to repair this defect?
- A. Cardiopulmonary bypass surgery
- B. Coil insertion in the catheterization laboratory
- C. Indomethacin administration
- D. Observation for spontaneous closure
Correct Answer: B
Rationale: This murmur is characteristic of a PDA and, because of cardiac enlargement, represents a larger shunt, requiring repair. Infants older than 8 months may have a coil or plug inserted into the shunt in the cardiac catheterization laboratory.
Klinefelter's syndrome:
- A. Has a karyotype XXV
- B. Is the result of meiotic non-dysjunction
- C. Shows delay in bone age/maturation
- D. Is a recognised cause of hypogonadotrophic hypogonadism
Correct Answer: B
Rationale: Klinefelter's syndrome is caused by meiotic non-dysjunction, resulting in an extra X chromosome (karyotype XXY). It is not inherited as an X-linked recessive trait, and it is not a cause of hypogonadotrophic hypogonadism.