Which clinical manifestation is included in toxic shock syndrome?
- A. Severe hypertension
- B. Subnormal temperature
- C. Erythematous macular rash
- D. Papular rash over extremities
Correct Answer: C
Rationale: One of the diagnostic criteria for toxic shock syndrome is a diffuse macular erythroderma. Hypotension is one of the manifestations. Fever of 38.9° C or higher is a characteristic. Desquamation of the palms and soles of the feet occurs in about 1 to 2 weeks.
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The most common coronary artery anomaly in Tetralogy of Fallot is
- A. Left anterior descending artery from right aortic sinus
- B. Single coronary artery from right aortic sinus
- C. Single coronary artery from left aortic sinus
- D. Left circumflex coronary artery from right aortic sinus
Correct Answer: A
Rationale: The most common coronary artery anomaly in Tetralogy of Fallot is the left anterior descending artery arising from the right aortic sinus.
Clinical manifestations of haemophilia include:
- A. Bleeding following neonatal intramuscular injection
- B. Intracranial bleeding
- C. Gingival bleeding
- D. Menorrhagia
Correct Answer: B
Rationale: Intracranial bleeding is a serious and potentially life-threatening manifestation of hemophilia, particularly in severe cases.
A nurse is caring for a child with a diagnosis of Kawasaki disease. Which of the following is a common complication of this disease?
- A. Pulmonary hypertension
- B. Aneurysms of the coronary arteries
- C. Diabetes mellitus
- D. Ventricular arrhythmias
Correct Answer: B
Rationale: Aneurysms of the coronary arteries are a common and serious complication of Kawasaki disease.
The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct?
- A. “You may need to increase the caloric density of your infant’s formula.â€
- B. “You should feed your baby every 2 hours.â€
- C. “You may need to increase the amount of formula your infant eats with each feeding.â€
- D. “You should place a nasal oxygen cannula on your infant during and after each feeding.â€
Correct Answer: A
Rationale: The metabolic rate of infants with heart failure is greater because of poor cardiac function and increased heart and respiratory rates. Their caloric needs are greater than those of the average infants, yet their ability to take in the calories is diminished by their fatigue. Infants with heart failure should be fed every 3 hours; a 2-hour schedule does not allow for enough rest, and a 4-hour schedule is too long. Fluids must be carefully monitored because of the heart failure. Infants do not require supplemental oxygen with feedings.
An emergency department nurse triages clients who present with chest discomfort. Which client should the nurse plan to assess first?
- A. A 42-year-old female who describes her pain as a dull ache with numbness in her fingers
- B. A 49-year-old male reports moderate pain that is worse on inspiration
- C. A 53-year-old female reports substernal pain that radiates to her abdomen
- D. A 58-year-old male describes his pain as an intense stabbing that spreads across his chest
Correct Answer: D
Rationale: Intense stabbing chest pain that spreads across the chest is highly suggestive of an acute cardiac event, such as a myocardial infarction, and requires immediate assessment.
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