Nokea
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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Which physiological changes occur as a result of hypoxemia in congestive heart failure (CHF)?
- A. Polycythemia and clubbing
- B. Anemia and barrel chest
- C. Increased white blood cells and low platelets
- D. Elevated erythrocyte sedimentation rate and peripheral edema
Correct Answer: A
Rationale: Hypoxemia stimulates erythropoiesis, causing polycythemia, which along with chronic hypoxemia can lead to digital clubbing.
Complement C3 levels are decreased in:
- A. Systemic lupus erythematoses
- B. Henoch-Schoenlein purpura
- C. Haemolytic uraemic syndrome
- D. Type II membrano-proliferative glomerulonephritis
Correct Answer: A
Rationale: Decreased C3 levels are characteristic of systemic lupus erythematosus due to immune complex deposition and complement consumption.
A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurse's best response?
- A. Squatting increases the return of venous blood back to the heart.
- B. Squatting decreases arterial blood flow away from the heart.
- C. Squatting is a common resting position when a child is tachycardic.
- D. Squatting increases the workload of the heart.
Correct Answer: A
Rationale: The squatting position allows the child to breathe more easily because systemic venous return is increased.
A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates?
- A. Seizure activity
- B. Hypoxia
- C. Sydenham’s chorea
- D. Decreasing level of consciousness
Correct Answer: C
Rationale: As the effects of rheumatic fever affect the central nervous system, the child may develop Sydenham’s chorea, manifested by involuntary, purposeless movements of the limbs.
Dome and dart P wave in lead V1 in electrocardiogram is suggestive of which of the following?
- A. Dextrocardia
- B. Left atrial ectopic rhythm
- C. Biatrial enlargement
- D. Mitral stenosis
Correct Answer: C
Rationale: The dome and dart P wave morphology is characteristic of biatrial enlargement, often seen in conditions like mitral stenosis and atrial fibrillation.