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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In congenital hypertophic pulmonary stenosis
- A. Metabolic alkalosis occurs
- B. In some cases can be treated with non surgical methods
- C. During surgery tumor is removed
- D. Is a caus of conjugated hyperbilirubinaemia in neonate
Correct Answer: B
Rationale: Some cases of congenital hypertrophic pulmonary stenosis can be managed with non-surgical techniques like balloon valvuloplasty.
Complement C3 levels are decreased in:
- A. Systemic lupus erythematoses
- B. Henoch-Schoenlein purpura
- C. Haemolytic uraemic syndrome
- D. Type II membrano-proliferative glomerulonephritis
Correct Answer: A
Rationale: Decreased C3 levels are characteristic of systemic lupus erythematosus due to immune complex deposition and complement consumption.
In childhood asthma:
- A. Over 90% of patients show exercise-induced bronchoconstriction
- B. Hypercapnia is the first physiological disturbance in status asthmaticus
- C. Infants are unresponsive to bronchodilators
- D. Spontaneous cure occurs before adolescence
Correct Answer: D
Rationale: Spontaneous cure before adolescence is a recognized phenomenon in childhood asthma, though not all cases resolve. Other options are incorrect: exercise-induced bronchoconstriction is common but not universal, hypercapnia occurs late in status asthmaticus, and infants do respond to bronchodilators.
A diagnosis of primary pulmonary hypertension of the newborn can be made if:
- A. Oxygen saturation in the hand is 80% and in the foot 67%
- B. A tachypnoeic baby has a saturation of 60%
- C. A baby with history of being covered in thick meconium at birth has PaO2 of 4kPa
- D. A septic baby is hypoxic in 100% oxygen
Correct Answer: A
Rationale: A significant difference in oxygen saturation between the upper and lower extremities (e.g., hand 80%, foot 67%) is indicative of persistent pulmonary hypertension of the newborn (PPHN).
Mitral valve prolapse
- A. Occurs in congenital myxomatous valves
- B. Need a Sx
- C. Rare cause of MR
- D. Need prophylactic antibiotics
Correct Answer: A
Rationale: Mitral valve prolapse often occurs in congenital myxomatous valves.