Nokea
The school nurse has been following a child who frequently complains of dizziness and headache. Today, she is brought in after fainting in the cafeteria following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. The nurse suspects she has:
- A. Transposition of the great vessels
- B. Coarctation of the aorta (COA)
- C. Aortic stenosis (AS)
- D. Pulmonic stenosis (PS)
Correct Answer: B
Rationale: In older children, COA can cause elevated blood pressure, headache, fainting, and bounding radial pulses.
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Which of the following is a neurocutaneous syndrome without cutaneous manifestations?
- A. Sturge-Weber syndrome
- B. Tuberous sclerosis
- C. Ataxia telangiectasia
- D. Von Hippel-Lindau disease
Correct Answer: D
Rationale: Von Hippel-Lindau disease is a neurocutaneous syndrome that primarily affects internal organs and often lacks cutaneous manifestations.
Functional causes of opening Snap (either due to swift opening of AV valve or due to excess flow across the valve) is seen in all, except
- A. Mitral regurgitation
- B. Ventricular septal defect
- C. Atrial septal defect
- D. First degree AV block
Correct Answer: D
Rationale: First degree AV block is not typically associated with an opening snap.
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.
A male client with a history of asthma reports having episodes of bronchoconstriction and increased mucous production while exercising. Which action should the nurse implement?
- A. Determine if the client is using an inhaler before exercising
- B. Advise the client to avoid all physical activity
- C. Encourage the client to increase fluid intake before exercise
- D. Recommend the client wear a mask while exercising
Correct Answer: A
Rationale: Using an inhaler before exercise can help manage asthma symptoms by preventing bronchoconstriction during physical activity.
Symptoms in patients with aortic stenosis depend on the severity of the obstruction EXCEPT
- A. cardiomegaly
- B. pulmonary congestion
- C. weak pulses
- D. pale skin
Correct Answer: D
Rationale: Pale skin is not a typical symptom of aortic stenosis.