An infant with a congenital cyanotic heart defect has a complete blood count drawn, revealing an elevated red blood cell (RBC) count. Which condition do these findings indicate?

Correct Answer: D

Rationale: The elevated RBC count in an infant with a congenital cyanotic heart defect indicates the body's response to chronic hypoxia by producing more RBCs to compensate for decreased oxygen levels. This is known as hypoxia compensation. Anemia (choice A) is characterized by decreased RBC count, dehydration (choice B) does not typically cause elevated RBC count, and jaundice (choice C) is related to liver function and bilirubin levels, not RBC count.

Correct Answer: B

Rationale: The correct answer is B: Assess for early signs of endocarditis. During the acute phase of rheumatic fever, endocarditis can develop as a complication due to the inflammation and damage to the heart valves. Early detection of endocarditis is crucial to prevent serious complications. By assessing for early signs such as new or changing heart murmurs, fever, fatigue, and shortness of breath, the nurse can promptly intervene and prevent further damage to the heart valves. Encouraging ambulation, maintaining hydration, and managing pain are important aspects of care but assessing for endocarditis takes precedence due to its potential impact on the patient's health and outcomes.

Correct Answer: C

Rationale: The correct answer is C: Elevated pulmonary artery wedge pressure (PAWP) or PAOP. In this scenario, the left coronary artery blockage has led to decreased cardiac function, causing increased pressure in the pulmonary circulation leading to pulmonary edema. PAWP reflects left ventricular end-diastolic pressure, which is elevated in conditions like heart failure. Elevated central venous pressure (A) may be seen in heart failure but is not specific to this diagnosis. Elevated blood pressure (B) is not typically associated with uncompensated heart failure. Increased oxygen saturation (D) is not consistent with the diagnosis, as pulmonary edema often leads to decreased oxygen saturation due to impaired gas exchange.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Handling pacemaker leads and a toaster simultaneously can lead to interference with the device, so the patient understands the importance of avoiding this. 2. This answer demonstrates awareness of potential risks and shows the patient's commitment to safety. 3. Options B, C, and D do not directly address safe care of the pacemaker site or demonstrate understanding of potential risks. 4. Option B focuses on obtaining a medic alert tag but does not address specific care instructions for the pacemaker site. 5. Option C assumes that the OR environment guarantees no risk of infection, which is incorrect. 6. Option D's reference to avoiding a home microwave is not necessary for pacemaker care unless the microwave is very old and poorly shielded.

Correct Answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin is a positive inotrope, meaning it increases the force of heart contractions, improving cardiac output in heart failure. It also has a negative chronotropic effect by slowing the heart rate, which can be beneficial in certain heart conditions. Option A is incorrect because digoxin has a positive inotropic effect. Option C is incorrect as it contradicts itself by stating both negative and positive inotropic effects. Option D is incorrect because digoxin does not have a positive chronotropic effect; it actually slows the heart rate.