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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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Regarding coarctation of aorta
- A. Associated with Turner's syndrome
- B. Commonest is preductal type
- C. Radio femoral delay is a feature
- D. Systolic BP in lower limb is higher than in upper limb
Correct Answer: C
Rationale: Radio-femoral delay is a characteristic feature of coarctation of the aorta due to the obstruction in blood flow.
In congenital hypertrophic pyloric stenosis:
- A. Conjugated hyperbilirubinaemia may be seen
- B. Hypokalaemia is due to vomiting
- C. Blood pH is high and urinary pH is low
- D. First-born males are commonly affected
Correct Answer: B
Rationale: Hypokalaemia in congenital hypertrophic pyloric stenosis is typically due to the loss of potassium through vomiting.
What is the Duke Treadmill score for a patient who exercised for 10 minutes (12 METS) and had a maximum of 1 mm ST depression at peak exercise without angina?
- A. 5
- B. 7
- C. 9
- D. 10
Correct Answer: C
Rationale: The Duke Treadmill score is calculated based on exercise duration
A young female client with seven children is having frequent morning headaches, dizziness, and blurred vision. Her blood pressure (BP) is 168/104 mmHg. The client reports that her husband recently lost his job and she is not sleeping well. After administering a STAT dose of an antihypertensive IV medication, which intervention is most important for the nurse to implement?
- A. Measure urine output hourly to assess for rental perfusion
- B. Request a prescription for pain medication
- C. Use an automated BP machine to monitor for hypotension
- D. Provide a quiet environment with low lighting
Correct Answer: C
Rationale: Monitoring blood pressure is crucial after administering an antihypertensive to ensure the client does not become hypotensive.
What is the primary nursing intervention to prevent bacterial endocarditis?
- A. Institute measures to prevent dental procedures.
- B. Counsel parents of high-risk children about prophylactic antibiotics.
- C. Observe children for complications, such as embolism and heart failure.
- D. Encourage restricted mobility in susceptible children.
Correct Answer: B
Rationale: The objective of nursing care is to counsel the parents of high-risk children about both the need for prophylactic antibiotics for dental procedures and the necessity of maintaining excellent oral health. The child’s dentist should be aware of the child’s cardiac condition. Dental procedures should be done to maintain a high level of oral health. Prophylactic antibiotics are necessary. Children should be observed for complications such as embolism and heart failure and restricted mobility should be encouraged in susceptible children, but maintaining good oral health and prophylactic antibiotics is important.