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. Booster seats are used for older children who have outgrown their forward-facing car seats. A 24- month-old toddler is typically too young and small for a booster seat.
B. Rear-facing car seats provide the best protection for young children, including toddlers, in the event of a crash.
B. The American Academy of Pediatrics (AAP) recommends keeping children in a rear-facing car seat until they reach the maximum height or weight limit. Rear-facing seats distribute crash forces more evenly across the back of the car seat and the child's body, reducing the risk of injury to the head, neck, and spine.
C. Placing a car seat forward-facing in the front passenger side and inactivating the airbag is not recommended for any child under the age of 13 due to the risk of injury from the airbag in the event of a crash.
D. Placing a car seat rear-facing in the front passenger side is not recommended, especially for a toddler.
Correct Answer is B
Explanation
Turning and repositioning the client at regular intervals is essential for preventing pressure ulcers in pediatric clients, especially those in the PICU who may be immobilized or have limited mobility due to their condition or treatment. Repositioning helps relieve pressure on bony prominences and redistributes pressure on the skin, reducing the risk of pressure ulcers. Turning schedules should be individualized based on the child's condition, mobility, and risk factors for pressure ulcers.
A. Avoid the use of a draw sheet when turning: Using a draw sheet can facilitate safe and smooth turning of the client without causing shear or friction forces. It helps distribute the weight evenly and reduces the risk of injury to the client or caregiver during the turning process. Therefore, avoiding the use of a draw sheet may increase the risk of pressure ulcers rather than prevent them.
B. Post a turning schedule at the client's bedside: While posting a turning schedule may serve as a reminder for staff, it alone does not provide direct intervention to prevent pressure ulcers. The crucial aspect is implementing the turning schedule consistently and ensuring that the client is repositioned at appropriate intervals.
C. Vigorously massage lotion into bony prominences: Massaging lotion into bony prominences can increase friction and shear forces on the skin, potentially causing tissue damage rather than preventing pressure ulcers. Additionally, vigorous massage may be uncomfortable or painful for the client, especially if they have fragile skin or existing pressure ulcers.
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