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A 17-year-old athlete presents to the clinic for her annual sports
physical examination. She reports fluctuations in her heart rate
that she has noted on her fitness tracker. She reports no
symptoms. You order an ECG due to a significant family history of
cardiovascular disease. While connected to the ECG, you note
the R-R interval is reduced when the patient breathes in and is
prolonged when she breathes out. Which of the following is the
most likely diagnosis for this patient?
A.
Pulsus paradoxus
B.
Pulmonary flow murmur
C.
,Respiratory sinus arrhythmia
D.
Sinus bradycardia Correct Answer C.
Respiratory sinus arrhythmia
The most likely diagnosis for this patient is respiratory sinus
arrhythmia (C). Respiratory sinus arrhythmia is defined as an
increase in HR with inspiration and decrease in HR with
expiration, as detected on this patient's ECG.
Pulsus paradoxus (A) is defined as a drop in systolic blood
pressure of > 10 mm Hg with inspiration and is often seen with
life-threatening pericardial disease
A 16-year-old boy presents to the clinic with his parents for a
follow-up on diagnostic test results that suggest a serious health
condition. The nurse practitioner presents an explanation of the
test results, the health condition, treatment options, and potential
care plans to the patient and his parents. Which of the core
concepts of patient- and family-centered care is the nurse
practitioner demonstrating?
A.
Collaboration
,B.
Dignity and respect
C.
Information sharing
D.
Participation Correct Answer C.
Information sharing
Patient- and family-centered care is an approach to health care
that recognizes the importance of the patient and their family as
partners in care. The four core concepts of patient- and family-
centered care are collaboration, dignity and respect, information
sharing, and participation. Information sharing (C) involves
providing the patient and their family with clear, accurate, and
timely information about their condition, treatment options, and
care plan.
A 15-year-old boy is brought to the clinic by his parent for a rash.
The rash started as one round lesion for 1 week but has now
progressed into multiple itchy, pink, and scaly lesions all over the
trunk. Which is true regarding this condition?
, A.
A topical antihistamine and antifungal is necessary to treat this
lesion
B.
This lesion requires a dermatology referral for more intensive
treatment
C.
This lesion should be kept covered, as it is contagious
D.
This lesion/condition may take several months to resolve Correct
Answer D.
This lesion/condition may take several months to resolve
The described dermatologic condition is consistent with pityriasis
rosea. Classic pityriasis rosea begins with a herald patch on the
trunk in up to 90% of cases but may not always be present. The
patch may be defined as erythematous with slightly elevated
scaling borders and a lighter depressed center. Progression of the
rash can occur for up to 6 weeks into a generalized rash and may
take on a fir-tree pattern. Therefore, the rash may take several
months to resolve (D) altogether. Pruritus is present in up to 50%
of cases. There are also noted prodromal constitutional