Nokea
A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurse’s best response?
- A. Squatting increases the return of venous blood back to the heart.
- B. Squatting decreases arterial blood flow away from the heart.
- C. Squatting is a common resting position when a child is tachycardic.
- D. Squatting increases the workload of the heart.
Correct Answer: A
Rationale: The squatting position allows the child to breathe more easily because systemic venous return is increased.
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Guillain-Barre syndrome (GBS) is excluded by:
- A. A normal CSF
- B. The presence of autonomic neuropathy
- C. Distinct sensory level
- D. Ophthalmoplegia
Correct Answer: C
Rationale: A distinct sensory level is not a feature of GBS, which typically presents with ascending symmetrical weakness and absent reflexes.
A nurse cares for a client who is prescribed magnetic resonance imaging (MRI) of the heart. The client’s health history includes a previous myocardial infarction and pacemaker implantation. Which action should the nurse take?
- A. Schedule an electrocardiogram just before the MRI.
- B. Notify the healthcare provider before scheduling the MRI.
- C. Call the physician and request a laboratory draw for cardiac enzymes.
- D. Instruct the client to increase fluid intake the day before the MRI.
Correct Answer: B
Rationale: Clients with pacemakers are generally not candidates for MRI due to the risk of device malfunction or tissue damage. The healthcare provider must be notified to determine the best course of action.
Left axis deviation of the QRS complex is associated with all the following except
- A. Inflow ventricular septal defect
- B. Pulmonary atresia with intact interventricular septum
- C. Double outlet right ventricle with subaortic ventricular septal defect
- D. Noonan syndrome with pulmonary stenosis
Correct Answer: A
Rationale: Left axis deviation is not typically associated with inflow ventricular septal defect.
Which is the leading cause of death after heart transplantation?
- A. Infection
- B. Rejection
- C. Cardiomyopathy
- D. Heart failure
Correct Answer: B
Rationale: The posttransplant course is complex. The leading cause of death after cardiac transplantation is rejection. Infection is a continued risk secondary to the immunosuppression necessary to prevent rejection. Cardiomyopathy is one of the indications for cardiac transplant. Heart failure is not a leading cause of death.
The vast majority of tumors originating from the heart are benign. Of the following, the MOST common pediatric cardiac tumors are
- A. fibromas
- B. rhabdomyomas
- C. myxomas
- D. hemangiomas
Correct Answer: B
Rationale: Rhabdomyomas are the most common benign cardiac tumors in children.