Nokea
A 5-year-old child has an elevated blood pressure during a well child exam. The primary care pediatric nurse practitioner notes mottling and pallor of the child's feet and lower legs and auscultates a systolic ejection murmur in the left infraclavicular region radiating to the child's back. The nurse practitioner will suspect which condition?
- A. Aortic stenosis (AS)
- B. Coarctation of the aorta (COA)
- C. Patent ductus arteriosus (PDA)
- D. Pulmonic stenosis
Correct Answer: B
Rationale: Coarctation of the aorta may not have symptoms until later childhood and may present as high blood pressure in the upper extremities and poor perfusion in the lower extremities.
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A nursing action that promotes ideal nutrition in an infant with congestive heart failure (CHF) is:
- A. Feeding formula that is supplemented with additional calories.
- B. Allowing the infant to nurse at each breast for 20 minutes.
- C. Providing large feedings every 5 hours.
- D. Using firm nipples with small openings to slow feedings.
Correct Answer: A
Rationale: Supplementing formula with extra calories increases the caloric density to support growth in infants with CHF.
The MOST common cause of sudden death in competitive athletes is
- A. aortic stenosis
- B. hypertrophic cardiomyopathy
- C. coronary artery abnormalities
- D. myocarditis
Correct Answer: B
Rationale: Hypertrophic cardiomyopathy is the leading cause of sudden death in competitive athletes.
A feature of Turner syndrome is:
- A. Short stature
- B. Polydactyly
- C. Congenital heart defects
- D. Mental retardation
Correct Answer: A
Rationale: Short stature is a common feature of Turner syndrome, along with ovarian insufficiency and other physical abnormalities.
An 8-year-old female presents with chest pain of 1 day's duration. Five days prior to the pain, she had fever, chills, and myalgias. Physical examination reveals an uncomfortable, anxious, afebrile patient with tachycardia, no murmur, and distant heart sounds. The chest x-ray is shown in Figure 19-2. There is a paradoxical pulse of 22 mm Hg. The most likely diagnosis is
- A. myocarditis
- B. cardiomyopathy
- C. Kawasaki disease
- D. pericarditis
Correct Answer: D
Rationale: Pericarditis causes distant heart sounds, paradoxical pulse, and can follow viral illnesses.
Bed-wetting can be considered normal up to
- A. 4 years in boys and 5 years in girls
- B. 5 years in boys and 4 years in girls
- C. 4 years in both boys and girls
- D. 5 years in both boys and girls
Correct Answer: D
Rationale: Bed-wetting is considered normal up to 5 years of age in both boys and girls, as bladder control develops gradually.