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A 2-month-old male presents with tachycardia, dyspnea, tachypnea, and a gallop rhythm with no heart murmur. He was perfectly well until 1 day prior to the episode. The physical examination reveals a heart rate of 235, a temperature of 37.8°C, and a normal blood pressure with warm, well-perfused extremities. The most likely diagnosis is
- A. sepsis
- B. supraventricular tachycardia
- C. ingestion
- D. ventricular tachycardia
Correct Answer: B
Rationale: Supraventricular tachycardia can cause rapid heart rates and heart failure in infants.
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A cardiac catheterization of a client with heart disease indicates the following blockages: 95% proximal left anterior descending (LAD), 99% proximal circumflex, and ? % proximal right coronary artery (RCA). The client later asks the nurse 'what does all this mean for me?' What information should the nurse provide?
- A. Blood supply to the heart is diminished by atherosclerotic lesions, which necessitate lifestyle changes.
- B. Blood vessels supplying the pumping chamber have blockages indicating a past heart attack.
- C. Three main arteries have major blockages, with only 1 to 5% of blood flow getting through to the heart muscle.
- D. The heart is not receiving enough blood, so there is a risk of heart failure and fluid retention.
Correct Answer: C
Rationale: This explanation provides a clear understanding of the severity of the blockages and the implications for the client's heart function.
List THREE medical management plans for biatrial enlargement.
- A. Loop diuretics (carefully)
- B. Beta-blockers (carefully)
- C. Anticoagulation
- D. All of the above
Correct Answer: D
Rationale: These are standard treatment options aimed at managing heart function, reducing fluid buildup, and preventing complications like clot formation.
Which of the following statements is incorrect regarding delayed tooth eruption?
- A. Most common cause is idiopathic
- B. Defined as no teeth eruption by 15 months of age
- C. Mechanical blockade can be a cause
- D. Hypothyroidism and hypoparathyroidism should be ruled out
Correct Answer: B
Rationale: Delayed tooth eruption is defined as no teeth eruption by 13 months of age, not 15 months.
Congenital complete heart block
- A. Corrected TGA
- B. SLE mother's child
- C. Plonged QT
- D. MgSO4 therapy to mother
Correct Answer: B
Rationale: Congenital complete heart block is often associated with mothers who have systemic lupus erythematosus.
Which of the following children are abnormal?
- A. 18-month-old who is able to put three blocks on top of each other and has a 2-word vocabulary
- B. 3-month-old who has just attained good head control, and is reaching for objects
- C. 5-year-old with difficulty in reading sentences from a book
- D. Bottom-shuffler who is still not walking at 16 months
Correct Answer: C
Rationale: A 5-year-old with difficulty reading sentences from a book may indicate a developmental or learning disorder, which is considered abnormal for that age.