Which group of clinical manifestations is indicative of Truncus Arteriosus?
Bounding pulses, heart failure within weeks, activity intolerance.
Cracked Lips, joint pain, thrombocytosis.
High upper extremity blood pressure (BP), weak distal pulses.
Squatting, irritability, peri-oral cyanosis.
The Correct Answer is A
Rationale:
A. Bounding pulses, heart failure within weeks, activity intolerance: Truncus arteriosus involves a single large vessel overriding both ventricles. This results in increased pulmonary blood flow, leading to early-onset heart failure. Bounding pulses occur from wide pulse pressure, and activity intolerance is related to poor oxygen delivery to tissues during exertion.
B. Cracked lips, joint pain, thrombocytosis: These symptoms are more consistent with Kawasaki disease, rather than a congenital heart defect like truncus arteriosus. Kawasaki disease often presents with mucocutaneous changes, arthritis, and elevated platelet counts.
C. High upper extremity blood pressure (BP), weak distal pulses: This is more indicative of coarctation of the aorta, where narrowing of the aorta leads to hypertension in the upper extremities and diminished pulses in the lower extremities. It is not characteristic of truncus arteriosus.
D. Squatting, irritability, peri-oral cyanosis: These symptoms are typical of Tetralogy of Fallot. Squatting helps increase systemic vascular resistance to reduce right-to-left shunting, and peri-oral cyanosis results from chronic hypoxemia, which is not the hallmark of truncus arteriosus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E","G"]
Explanation
Rationale:
A. Metformin twice a day, taken with food to prevent GI upset: Metformin is the first-line medication for Type 2 Diabetes and helps improve insulin sensitivity. Taking it with food reduces gastrointestinal side effects, making this a key part of treatment.
B. Long acting lantus before bed to control blood sugar overnight: While insulin may be necessary in some Type 2 Diabetes cases, especially with significant hyperglycemia, it is not typically the initial treatment for newly diagnosed adolescents. It is more common in Type 1 Diabetes or advanced Type 2.
C. Rapid Acting Insulin dosed using a sliding scale before every meal: Sliding scale insulin is generally reserved for Type 1 Diabetes or severe cases of Type 2 Diabetes with uncontrolled glucose. It is not the standard initial treatment in newly diagnosed Type 2 adolescents.
D. Consistent aerobic exercise every day with a goal of 60 minutes per day: Regular physical activity is essential in managing Type 2 Diabetes as it improves insulin sensitivity and aids in weight management.
E. Regular blood sugar monitoring throughout the day: Monitoring blood glucose levels helps track the effectiveness of treatment and guides lifestyle or medication adjustments in Type 2 Diabetes management.
F. Use of a continuous subcutaneous insulin pump to control blood sugar: Insulin pumps are typically used for Type 1 Diabetes. Their use in Type 2 Diabetes is rare and usually reserved for specific cases, not standard treatment.
G. Well balanced diet and monitoring simple sugar intake: Dietary management focusing on balanced nutrition and limiting simple sugars is fundamental in controlling Type 2 Diabetes and preventing glucose spikes.
Correct Answer is ["B","C","D","E","F"]
Explanation
Rationale:
A. Jaundice: This is not part of the Jones Criteria for rheumatic fever. While jaundice may occur with certain liver or hemolytic conditions, it is unrelated to the pathophysiologic features of rheumatic fever.
B. Subcutaneous Nodules: These are firm, painless nodules typically found over bony prominences or near joints and are a recognized major criterion for rheumatic fever. They are associated with severe carditis and indicate inflammation of connective tissue.
C. Polyarthritis: This is one of the most common major criteria. It involves migratory inflammation affecting large joints, with swelling, redness, and pain that shifts from one joint to another over several days.
D. Chorea: Also called Sydenham chorea or “St. Vitus dance,” this involves involuntary, purposeless movements and is a major neurological manifestation of rheumatic fever. It can appear weeks to months after the initial streptococcal infection.
E. Carditis: This includes inflammation of the heart’s endocardium, myocardium, and/or pericardium. Carditis is a major criterion and can present with new murmurs, cardiomegaly, or signs of heart failure.
F. Erythema Marginatum: This is a distinctive, non-pruritic, pink rash with a clear center and wavy margins that spreads outward. It is one of the major cutaneous manifestations in the Jones Criteria.
G. Decreased urine output: This is not part of the Jones Criteria and is more indicative of renal involvement, such as in acute glomerulonephritis, which can occur after streptococcal infections but is a separate condition from rheumatic fever.
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