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. Application of antibiotic ointment to the pin sites is not necessary as pins drilled into the bone are not used in buck extension traction.
B. Traction can be removed briefly during baths in cases where a pre-made boot is being used
C. Adequate hydration is essential for overall health and well-being, and fluid restriction could lead to dehydration, especially in a child with increased metabolic demands due to illness or injury.
D. Repositioning every 2 hours may not be necessary, as the child's position is generally stable with the traction device in place.
Correct Answer is C
Explanation
A. This statement does not directly relate to meeting the nutritional needs of an infant with heart failure. Also, setting a specific time limit on crying before feeding may not always be practical or effective.
B. Infants with heart failure may have increased energy needs due to the increased work of the heart. Feeding on demand or more frequently may be necessary to meet the infant's nutritional requirements.
C. In heart failure, infants may tire easily during feeding due to fatigue from poor cardiac function. Allowing the baby to feed at their own pace can help prevent exhaustion and ensure adequate intake.
D. Polycose is a carbohydrate supplement that may be used to increase the caloric density of formula or breast milk for infants with heart failure who require additional calories. Adding Polycose to every bottle may not be appropriate.
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