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 D
Explanation
A: This response indicates that the parents understand the need to manage the child's symptoms, which is important, but it does not directly relate to preventing the transmission of the disease to others.
B: Monitoring the child's temperature is a part of caring for someone with an illness, but like option A, it does not address the prevention of spreading the infection.
C: Ensuring the child stays hydrated is crucial when they are ill, especially with a throat infection, as it can help soothe the throat and keep the child comfortable. However, this practice is not specifically about preventing disease transmission.
D: This is the correct response that indicates an understanding of the teaching on preventing disease transmission. Streptococcal bacteria can contaminate toothbrushes, and using the same toothbrush after illness can lead to re-infection or spread the bacteria to others. Discarding the toothbrush after the infection can help prevent this.
Correct Answer is B
Explanation
To calculate the appropriate dosage of amoxicillin for the toddler; Given:
Weight of the toddler = 20 kg
Recommended dosage range = 20 to 25 mg/kg/day Calculate the total daily dose:
Minimum recommended dosage = 20 mg/kg/day Maximum recommended dosage = 25 mg/kg/day
Minimum total daily dose = 20 mg/kg/day × 20 kg = 400 mg/day Maximum total daily dose = 25 mg/kg/day × 20 kg = 500 mg/day
The prescribed dosage is 100 mg every 8 hours, which means 300 mg per day (100 mg × 3 times a day). As 300 mg is below the minimum recommended total daily dose (400 mg) for a toddler weighing 20 kg, the nurse should determine that the prescribed dosage is insufficient to achieve the desired effect.
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