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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What is one of the most frequent causes of hypovolemic shock in children?
- A. Sepsis
- B. Blood loss
- C. Anaphylaxis
- D. Congenital heart disease
Correct Answer: B
Rationale: Blood loss is the most frequent cause of hypovolemic shock in children. Sepsis causes septic shock, which is overwhelming sepsis and circulating bacterial toxins. Anaphylactic shock results from extreme allergy or hypersensitivity to a foreign substance. Congenital heart disease contributes to hypervolemia, not hypovolemia.
The reason that the hematocrit is so high is
- A. chronic hypoxia
- B. it was taken in a low cardiac output state
- C. it was a peripheral finger stick
- D. embolic stroke
Correct Answer: A
Rationale: Chronic hypoxia leads to secondary polycythemia as a compensatory mechanism.
In embryology:
- A. Most defects occur with teratogens in the first 2 weeks post-conception
- B. The urachus becomes the median umbilical ligament
- C. The mesonephric duct becomes the male organs
- D. The thyroid develops from the floor of the primitive larynx
Correct Answer: B
Rationale: The urachus becomes the median umbilical ligament. Most defects occur after the first 2 weeks, and the thyroid develops from the floor of the pharynx.
In urgent situations of supraventricular tachycardia (SVT) when symptoms of severe heart failure have already occurred, the initial management is
- A. adenosine by rapid intravenous push
- B. DC cardioversion
- C. verapamil
- D. digoxin
Correct Answer: B
Rationale: DC cardioversion is the preferred initial management in hemodynamically unstable SVT.
All the following statements about spontaneous coronary artery dissection are true, except
- A. More common in young females
- B. Proximal coronary involvement associated with immuno-inflammatory disease
- C. Intra-coronary imaging shows 'accordion sign'
- D. Physical stress precipitates it by causing intimal tear
Correct Answer: C
Rationale: The 'accordion sign' is not typically associated with spontaneous coronary artery dissection.