A child born with Down syndrome should be evaluated for which associated cardiac manifestation?
- A. Congenital heart defect (CHD)
- B. Systemic hypertension
- C. Hyperlipidemia
- D. Cardiomyopathy
Correct Answer: A
Rationale: CHD is found frequently in children with Down syndrome.
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Nurse Roy is administering total parental nutrition (TPN) through a peripheral I.V. line to a school-age child. What’s the smallest amount of glucose that’s considered safe and not caustic to small veins, while also providing adequate TPN?
- A. 5% glucose
- B. 10% glucose
- C. 15% glucose
- D. 17% glucose
Correct Answer: B
Rationale: A 10% glucose solution is safe for peripheral veins and provides adequate nutrition without causing irritation or damage.
A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever?
- A. Subcutaneous nodules and fever
- B. Painful, tender joints, and carditis
- C. Erythema marginatum and arthralgia
- D. Chorea and elevated sedimentation rate
Correct Answer: B
Rationale: The presence of two major Jones criteria would indicate a high probability of rheumatic fever.
During a routine well child exam on a 5-year-old child, a grade II/VI, harsh, late systolic ejection murmur at the upper left sternal border that transmits to both lung fields is auscultated. The child has normal growth and development. What will the nurse practitioner suspect?
- A. Aortic stenosis (AS)
- B. Patent ductus arteriosus (PDA)
- C. Pulmonic stenosis
- D. Tricuspid atresia
Correct Answer: C
Rationale: Pulmonic stenosis may be asymptomatic with a murmur as described above.
What are THREE long-term complications that can occur after repair of coarctation of the aorta in an infant?
- A. Berry aneurysms
- B. Persistent systemic hypertension
- C. Re-coarctation
- D. All of the above
Correct Answer: D
Rationale: Long-term follow-up is necessary for patients who have undergone repair of coarctation due to risks of recurrence or complications.
The following are strongly associated with Kawasaki disease EXCEPT
- A. duration of fever of >16 days
- B. first-degree heart block
- C. male gender
- D. age of <1 year
Correct Answer: B
Rationale: First-degree heart block is less commonly associated with Kawasaki disease compared to other factors.