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 A
Explanation
Notifying the provider allows for assessment of the situation, possibly perform a medical evaluation to determine if the bruises are of medical concern, and decide on further actions.
B. Ask the toddler what caused the bruises is not always reliable to provide information of sensitive issues. However, asking them can sometimes provide useful information.
C. Ask the parents what caused the bruises may mislead the team as the parents may lie about the bruises if they are perpetrators of child abuse.
D. Notification of social service is important in suspected cases of neglect or abuse. However, this should follow assessment by the provider
Correct Answer is B
Explanation
Red marks across the cheeks can be indicative of various conditions, including skin irritation, allergies, or infections. Before jumping to conclusions or taking further actions, the nurse should conduct a thorough assessment of the child's overall condition. Assessing the rest of the child's body for any additional signs or symptoms, such as a rash or other skin abnormalities, can provide more information about the cause of the red marks on the cheeks. Depending on the findings of the assessment, further action may be necessary, such as questioning the parents about potential causes or referring the family to appropriate services if there are concerns about the child's well-being. However, the initial step should be to assess the child's condition comprehensively.
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