Which is a common, serious complication of rheumatic fever?
- A. Seizures
- B. Cardiac arrhythmias
- C. Pulmonary hypertension
- D. Cardiac valve damage
Correct Answer: D
Rationale: Rheumatic fever is an inflammatory disease that can develop after a streptococcal infection, such as strep throat. One of the most serious complications of rheumatic fever is cardiac involvement, specifically damage to the heart valves. This occurs due to the body's immune response attacking the heart valves as a result of molecular mimicry between streptococcal antigens and human tissues. The damage to the heart valves can result in conditions like mitral valve stenosis or regurgitation, which can lead to heart failure if not managed appropriately. Therefore, cardiac valve damage is a common and serious complication of rheumatic fever that requires monitoring and treatment to prevent long-term consequences.
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Which is an accurate description of a Kasai procedure?
- A. A palliative procedure in which the bile duct is attached to a loop of bowel to assist with bile drainage.
- B. A curative procedure that connects the bile duct to the bowel.
- C. A curative procedure where the bile duct is banded.
- D. A palliative procedure where the bile duct is banded.
Correct Answer: A
Rationale: The Kasai procedure is a palliative surgery for biliary atresia that helps restore bile flow and delays the need for liver transplantation.
The nurse caring for a 14-year-old girl with DI understands which of the following about this disorder?
- A. DI is treated on a short-term basis with hormone replacement therapy.
- B. DI may cause anorexia if proper meal planning is not addressed.
- C. DI is treated with vasopressin on a lifelong basis.
- D. DI requires strict fluid limitation until it resolves.
Correct Answer: C
Rationale: Diabetes Insipidus (DI) is a condition characterized by the inability of the kidneys to conserve water, leading to excessive thirst and excretion of large volumes of dilute urine. Central DI, the most common form in children, is treated with a synthetic form of the hormone vasopressin, also known as desmopressin. Vasopressin helps the kidneys to retain water, thereby reducing urine output and preventing excessive dehydration. Since DI is a chronic condition, treatment with vasopressin is typically required on a lifelong basis to manage symptoms and prevent complications. It is important for healthcare providers to understand the long-term nature of DI treatment in order to provide appropriate care and support to patients with this condition.
Mr. Sison had an above the knee amputation (AKA). He is taught to use crutches while prosthesis is being adjusted. The nurse instruct the client to support her weight primarily on which areas?
- A. axilla
- B. upper arms
- C. elbows
- D. hands
Correct Answer: C
Rationale: When using crutches after an above the knee amputation, it is important for the client to support their weight primarily on their elbows. Placing the weight on the elbows helps to prevent pressure on the axilla (armpit area), which can lead to nerve damage and discomfort. Supporting weight on the elbows also provides better stability and control while using crutches, allowing the client to move more safely and comfortably. Additionally, distributing the weight onto the elbows helps to avoid potential strain and injury to the hands or upper arms.
These facts are true regarding the developmental stage of preschool children EXCEPT
- A. handedness is achieved by 3 years of age
- B. boys are usually later than girls in achieving bladder control
- C. knowing gender by 4 years
- D. musturbation
Correct Answer: D
Rationale: Musturbation is not a recognized developmental milestone.
The client with rheumatoid arthritis reports GI irritation after taking piroxicam (Feldene). To prevent GI upset, the nurse should provide which instruction?
- A. Space the administration every 4 hours.
- B. Use the drug for a short time only
- C. Take piroxicam with food or oral antacid
- D. Decrease the piroxicam dosage
Correct Answer: C
Rationale: Piroxicam is a nonselective NSAID (nonsteroidal anti-inflammatory drug) that can irritate the gastrointestinal (GI) tract, leading to symptoms such as heartburn, indigestion, and stomach pain. Taking piroxicam with food or an oral antacid can help reduce GI irritation by providing a protective barrier and reducing acid production within the stomach. Encouraging the client to take piroxicam with a meal or antacid can help prevent or minimize GI upset associated with the medication. Additionally, using a proton pump inhibitor (PPI) or histamine-2 receptor antagonist (H2 blocker) along with piroxicam may further protect the stomach lining from irritation.