Nokea
Which therapeutic management should the nurse expect to implement for a child with rheumatic fever?
- A. Administering penicillin
- B. Avoiding salicylates (aspirin)
- C. Imposing strict bed rest for 4 to 6 weeks
- D. Administering corticosteroids if chorea develops
Correct Answer: A
Rationale: The goal of medical management is the eradication of the hemolytic streptococci. Penicillin is the drug of choice. Salicylates can be used to control the inflammatory process, especially in the joints, and reduce the fever and discomfort. Bed rest is recommended for the acute febrile stage, but it does not need to be strict. The chorea is transient and will resolve without treatment.
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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.
Diamond Blackfan anemia is different from Transient Erythroblastopenia of Childhood as the former has
- A. Increased adenosine deaminase
- B. Mean corpuscular volume is decreased
- C. Female predominance
- D. Antecedent history of viral illness
Correct Answer: A
Rationale: Diamond Blackfan anemia is characterized by increased adenosine deaminase activity, unlike Transient Erythroblastopenia of Childhood.
The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is:
- A. It is always helpful to get a second opinion about any serious condition like this.
- B. Your baby's defect is small and will likely close on its own by 1 year of age.
- C. It is common for physicians to wait until an infant develops respiratory distress before they do the surgery.
- D. With a small defect like this, they wait until the child is 10 years old to do the surgery.
Correct Answer: B
Rationale: Most small VSDs close spontaneously within the first year of life.
SVT in children differ from physiologic sinus tachycardia by all the following EXCEPT
- A. sudden onset and termination
- B. persistent ventricular rate of >180 bpm
- C. fixed RR interval on ECG
- D. evident change in heart rate with activity
Correct Answer: D
Rationale: Physiologic sinus tachycardia can show changes in heart rate with activity, unlike SVT which has a fixed rate.
The most common cause for testicular pain in boys in 2-10 years of age is
- A. Testicular torsion
- B. Torsion of appendix testis
- C. Epididymitis
- D. Congenital varicocele
Correct Answer: B
Rationale: Torsion of the appendix testis is the most common cause of testicular pain in boys aged 2-10 years, as it involves the twisting of a small vestigial remnant.