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
B. The FLACC (Face, Legs, Activity, Cry, Consolability) scale is used to assess pain in infants and young children who may not be able to verbalize their pain. Each category is scored from 0 to 2, with a total score ranging from 0 to 10.
A. This scale uses facial expressions to depict pain levels and is typically used for children over 3 years old who can point to the face that represents their pain level.
C. Oucher is used for children who can communicate their pain by pointing to photographs of other children in pain. It is not suitable for infants.
D. Visual Analog Scale requires clients to mark their pain level on a line. It is not suitable for infants who cannot communicate their pain verbally or through such methods.
Correct Answer is D
Explanation
A. 15 angle is for intradermal injection not for intramuscular
B. The needle should be inserted into the middle third of the deltoid muscle, which is typically 2 to 3 finger widths below the acromion process.
C. A smaller gauge needle, such as 22 or 23, is often used for pediatric vaccinations to minimize discomfort. This should, however, be adjusted accordingly based on individual characteristics
D. Ashorter needle length, such as 1.8 mm (0.5 in), is typically appropriate for pediatric deltoid injections to avoid deep penetration
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