Nokea
Varying intensity of the first heart sound from a booming (bruit de canon) to virtual inaudibility is seen in which of the following?
- A. Mitral stenosis with atrial fibrillation
- B. Constant 2:1 AV block
- C. First-degree AV block
- D. Congenital complete heart block
Correct Answer: A
Rationale: In mitral stenosis with atrial fibrillation, the intensity of the first heart sound can vary depending on the dynamics of atrial contraction and ventricular filling.
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The nurse is assessing a child with acute otitis media. Which finding should the nurse expect?
- A. Bilateral eye discharge and fever
- B. A bulging, red tympanic membrane
- C. Nasal congestion and headache
- D. Persistent cough and sore throat
Correct Answer: B
Rationale: Acute otitis media typically presents with a bulging, red tympanic membrane due to fluid accumulation and infection.
A 12-year-old male tries out for a middle school hockey team. He has a history of a heart murmur as an infant, but the doctor thought it would go away. During the tryout, he experiences severe dyspnea and becomes light-headed. At your office, he has a normal rhythm, pulse, and blood pressure and is no longer dizzy. There is a grade 4/6 systole ejection murmur that radiates to the neck. There is also an ejection click. An ECG reveals left ventricular hypertrophy. The next approach to his management includes
- A. chest x-ray
- B. exercise test
- C. digitalization
- D. echocardiography
Correct Answer: D
Rationale: Echocardiography is essential to evaluate the severity of aortic stenosis and its effects on the heart.
After the nurse provides dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching?
- A. “Well follow these instructions until our child’s symptoms disappear.â€
- B. “Our child must maintain these dietary restrictions until adulthood.â€
- C. “Our child must maintain these dietary restrictions lifelong.â€
- D. “We’ll follow these instructions until our child has completely grown and developed.â€
Correct Answer: C
Rationale: Celiac disease requires lifelong adherence to a gluten-free diet to prevent symptoms and complications.
An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand regarding why dyspnea occurs?
- A. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
- B. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia.
- C. Blood is shunted past cardiac arteries, causing myocardial hypoxia.
- D. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.
Correct Answer: A
Rationale: When PDA is present, oxygenated blood recycles through the lungs, overburdening the pulmonary circulation.
Which of the following is an example of humanized anti-human IL-6 receptor monoclonal antibody?
- A. Infliximab
- B. Adalimumab
- C. Tocilizumab
- D. Anakinra
Correct Answer: C
Rationale: Tocilizumab is a humanized monoclonal antibody that targets the IL-6 receptor, used in treating inflammatory conditions.