An adolescent boy is admitted with the following symptoms: Slow onset of recurrent low-grade fever, fatigue, weakness, joint and muscle aches, loss of appetite, weight loss and diaphoresis.
On assessment the nurse auscultates a new heart murmur, splenomegaly, petechiae, splinter hemorrhages under the nails and Osler nodes (red, painful non-hemorrhagic nodules on the pads of fingers and toes.
Which of the following Acquired Heart Diseases does this best represent?
Infective endocarditis
Tetralogy of Fallot
Acute rheumatic fever
Pulmonary hypertension
The Correct Answer is A
A. The symptoms described, including slow onset of recurrent low-grade fever, fatigue, weakness, joint and muscle aches, loss of appetite, weight loss, and diaphoresis, along with the presence of a new heart murmur, splenomegaly, petechiae, splinter hemorrhages under the nails, and Osler nodes, are classic signs and symptoms of infective endocarditis (IE).
B. Tetralogy of Fallot is a congenital heart defect characterized by four specific abnormalities in the heart's structure. The symptoms described do not align with the characteristic features of Tetralogy of Fallot.
C. Acute rheumatic fever is an inflammatory condition that can develop as a complication of untreated streptococcal infections, particularly strep throat. While it can lead to heart valve damage (rheumatic heart disease), the symptoms described are more indicative of infective endocarditis rather than acute rheumatic fever.
D. Pulmonary hypertension is a condition characterized by elevated blood pressure in the pulmonary arteries. While it can present with symptoms such as fatigue and weakness, it typically does not manifest with the constellation of symptoms described, including fever, joint and muscle aches, and the presence of Osler nodes and splinter hemorrhages.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Pulling themselves up to a standing position is a motor milestone that is typically achieved around 9- 12 months of age. While delays in motor milestones can sometimes be concerning, they are not specific signs of autism at this age.
B. Autism is primarily characterized by social communication and interaction difficulties, as well as restricted and repetitive behaviors. At 10 months old, infants typically start to engage in social interactions, including making eye contact with caregivers
C. Parallel play is where children play alongside each other without interacting directly, is a social milestone that typically develops around 2-3 years of age.
D. Growth below the 5th percentile may indicate poor growth or failure to thrive, but it is not a specific behavioral sign of autism.
Correct Answer is B
Explanation
A. Gastritis is inflammation of the stomach lining and is typically not caused by streptococcal infections. There is no direct link between gastritis and rheumatic fever.
B. Rheumatic fever is an inflammatory condition that develops as a complication of inadequately treated Group A Streptococcus (GAS) infections such as strep throat.
Therefore, a history of a sibling having a sore throat 3 weeks ago is significant because it suggests a possible streptococcal infection.
C. Fifth disease, caused by parvovirus B19, is a viral infection that primarily affects children. It is not caused by streptococcal bacteria and is not associated with the development of rheumatic fever.
D. Chickenpox, caused by the varicella-zoster virus, is a viral infection and does not predispose a child to rheumatic fever.
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