In a 2-month-old infant, a machine-like continuous murmur is audible and heard loudest in the upper left sternal border (ULSB) during late systole. This finding could be suggestive of a:
pulmonary valve stenosis.
venous hum.
patent ductus arteriosus.
ventricular septal defect.
The Correct Answer is C
Rationale:
A. Pulmonary valve stenosis typically produces a systolic ejection murmur, not a continuous machine-like murmur.
B. A venous hum is continuous but usually heard over the right or left supraclavicular area and is benign.
C. Patent ductus arteriosus (PDA) classically produces a continuous, “machine-like” murmur best heard at the upper left sternal border. The murmur persists throughout systole and diastole due to continuous blood flow from the aorta to the pulmonary artery.
D. A ventricular septal defect usually produces a holosystolic murmur heard best at the lower left sternal border, not a continuous machine-like murmur.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Headaches and breast tenderness are more commonly associated with premenstrual syndrome (PMS) rather than dysmenorrhea.
B. Nausea, vomiting, and back pain are classic findings of dysmenorrhea, which is painful menstruation often caused by increased prostaglandin production leading to uterine contractions and associated systemic symptoms.
C. Urinary frequency and burning suggest a urinary tract infection rather than menstrual pain.
D. Vaginal dryness and pruritus are signs of irritation or hormonal changes, not dysmenorrhea.
Correct Answer is A
Explanation
Rationale:
A. Hypocalcemia in infants can present with neuromuscular irritability, which includes a stridorous or high-pitched cry, positive Chvostek sign (facial muscle twitching when the facial nerve is tapped), tremors, and vomiting. Early recognition and treatment are critical to prevent seizures or cardiac complications.
B. Gastroesophageal reflux may cause vomiting and irritability but does not produce Chvostek sign or tremulousness.
C. Whooping cough presents with paroxysmal coughing and inspiratory “whoop”, but stridor and Chvostek sign are not features.
D. Rickets is associated with bone deformities, delayed growth, and hypocalcemia over time, but the acute neuromuscular signs seen here suggest immediate evaluation for hypocalcemia.
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