Author Question: The nurse is admitting a patient to the adolescent unit. During the history and physical, the nurse ... (Read 70 times)

bb · **on:** Jun 28, 2018

The nurse is admitting a patient to the adolescent unit. During the history and physical, the nurse records the following symptoms: abrupt onset, tonsillar exudate, painful cervical lymphadenopathy, anorexia, nausea, vomiting, abdominal pain, severe

sore throat, headache, malaise, fever, and petechial mottling of soft palate. The nurse suspects the patient has which of the following? 1. Viral pharyngitis
2. Tonsillitis
3. Pharyngitis caused by group A beta-hemolytic streptococcus
4. Adenoiditis

Question 2

The nurse is caring for an infant diagnosed with failure to thrive. The nurse observes the physician taking blood pressures in all four extremities, and recognizes that the congenital cardiac defect suspected is:

1. Tetralogy of Fallot.

2. Pulmonary atresia.

3. Coarctation of the aorta.

4. Ventricular septal defect.

akemokai · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

3
Rationale:
1. Viral pharyngitis might have some of the symptoms but does not have petechial mottling of the soft palate.
2. Tonsillitis will have some of the symptoms but will not have petechial mottling of the soft palate, painful cervical lymphadenopathy, or severe sore throat.
3. Strep throat will have all of the above symptoms.
4. The adenoids are lymphatic tissue located on the posterior pharyngeal wall, and are sometime called the pharyngeal tonsils. They can manifest with acute or chronic infection.

Answer to Question 2

3

Rationale:

1. There are minimal differences between upper and lower blood pressure readings in tetralogy of Fallot.
2. There are minimal differences between upper and lower blood pressure readings in pulmonary atresia.
3. Normally, blood pressures in the lower extremities are the same or higher than upper-extremity blood pressures. But in coarctation of the aorta, the narrowing of the aorta causes decreased blood flow to the lower extremities, and so lower extremity blood pressure readings are significantly lower than upper-extremity readings.
4. There are minimal differences between upper and lower blood pressure readings in ventricular septal defect.