Which of the following is a serious complication of acute rheumatic fever?
- A. Seizures
- B. Coronary aneurysms
- C. Pulmonary hypertension
- D. Cardiac valve damage
Correct Answer: D
Rationale: The correct answer is D: Cardiac valve damage. Acute rheumatic fever can lead to inflammation of the heart valves, causing damage and leading to conditions like mitral stenosis or regurgitation. This occurs due to an autoimmune response triggered by a previous streptococcal infection. Choice A, seizures, is not typically associated with acute rheumatic fever. Choice B, coronary aneurysms, is more commonly linked to conditions like Kawasaki disease. Choice C, pulmonary hypertension, is not a typical complication of acute rheumatic fever. Thus, the correct answer is D, as it aligns with the known pathophysiology of the disease.
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Anorexia nervosa may best be described as:
- A. Occurring most frequently in adolescent males
- B. Occurring most frequently in adolescents from lower socioeconomic groups
- C. Resulting from a posterior pituitary disorder
- D. Resulting in severe weight loss in the absence of obvious physical causes
Correct Answer: D
Rationale: Anorexia nervosa is characterized by severe weight loss due to restrictive eating behaviors and distorted body image. Choice D is correct as it accurately describes the hallmark symptom of anorexia. Choices A and B are incorrect because anorexia nervosa is more common in adolescent females and does not discriminate based on socioeconomic status. Choice C is incorrect as anorexia nervosa is primarily a psychological disorder, not a pituitary disorder.
You are the nurse caring for a 3-year-old, 33-pound child on digoxin. The safe dose range for digoxin is 20-40 mcg/kg/day. The order is for digoxin to be given IV every 12 hours, what is the maximum safe single dose the child should receive?
- A. 300 mcg
- B. 600 mcg
- C. 660 mcg
- D. 1320 mcg
Correct Answer: A
Rationale: The correct answer is A: 300 mcg. To determine the maximum safe single dose, we first need to calculate the total daily safe dose range for the child. The child's weight is 33 pounds, which is approximately 15 kg (1 kg = 2.2 lbs). The safe dose range is 20-40 mcg/kg/day, so for a 15 kg child, the total daily safe dose range would be 300-600 mcg/day. Since the medication is given every 12 hours, the maximum safe single dose would be half of the total daily dose, which is 300 mcg. This ensures that the child stays within the safe dose range for digoxin. Choice B (600 mcg) exceeds the maximum daily safe dose, choice C (660 mcg) exceeds the daily safe dose range, and choice D (1320 mcg) is way above the safe dose range for the child's weight.
The nurse is caring for a child with frostbite would expect the patient to display:
- A. Redness and swelling of the hands
- B. Blisters that appear 24 to 48 hours after rewarming
- C. Itching and burning that persists after rewarming
- D. Fever
Correct Answer: B
Rationale: The correct answer is B because blisters appearing 24 to 48 hours after rewarming is a common symptom of frostbite. This occurs due to damage to the blood vessels and tissues. A: Redness and swelling are more indicative of mild frostbite. C: Itching and burning are not typical symptoms of frostbite. D: Fever is not a common symptom of frostbite.
Which should be the major consideration in selecting toys for a child who is cognitively impaired?
- A. Age appropriateness
- B. Ability to teach useful skills
- C. Safety
- D. Ability to provide exercise
Correct Answer: C
Rationale: The major consideration in selecting toys for a cognitively impaired child should be safety (Choice C). Safety is crucial as children with cognitive impairments may have difficulty understanding potential dangers or using toys appropriately. Age appropriateness (Choice A) is important, but safety should take precedence. Teaching useful skills (Choice B) can be beneficial but may not be the primary focus. Providing exercise (Choice D) is valuable, but ensuring safety should come first.
Which is the most accurate genetic explanation for a family with hemophilia?
- A. It is an X-linked recessive disorder
- B. It is an autosomal recessive disorder
- C. It is equally distributed among males and females
- D. It is a Y-linked dominant disorder
Correct Answer: A
Rationale: The correct answer is A: It is an X-linked recessive disorder. Hemophilia is caused by a mutation in genes located on the X chromosome. Males inherit the disorder from their mothers, as they only inherit one X chromosome. Females can be carriers if they inherit one mutated X chromosome. Autosomal recessive disorders (choice B) require both parents to pass on the mutated gene. Hemophilia is not equally distributed among males and females (choice C) because males are more likely to exhibit symptoms. Y-linked disorders (choice D) are inherited only by males and are passed from father to son.
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