Nokea
A nurse assesses a client who is recovering after a left-sided cardiac catheterization. Which assessment finding requires immediate intervention?
- A. Urinary output less than intake
- B. Bruising at the insertion site
- C. Slurred speech and confusion
- D. Discomfort in the left leg
Correct Answer: C
Rationale: Slurred speech and confusion may indicate a neurological complication, such as a stroke, which requires immediate intervention.
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What is the most likely congenital heart lesion in a newborn with Trisomy 21?
- A. AVSD
- B. Tetralogy of Fallot
- C. Ventricular septal defect
- D. Pulmonary stenosis
Correct Answer: A
Rationale: Atrioventricular septal defect (AVSD) is highly associated with Trisomy 21 and is the most likely congenital heart lesion in these infants.
What are THREE associated echo findings for an infant with wide spaced nipples and a webbed neck?
- A. LV systolic dysfunction
- B. Blunted abdominal aortic Doppler
- C. Bicuspid aortic valve
- D. All of the above
Correct Answer: D
Rationale: These are common echo findings that can be associated with congenital syndromes affecting the heart.
Cytosolic glycogen accumulation does not occur in
- A. Pompe disease
- B. Mc Ardle's disease
- C. Phosphofructokinase deficiency
- D. Phosphoglycerate kinase deficiency
Correct Answer: D
Rationale: Phosphoglycerate kinase deficiency does not lead to cytosolic glycogen accumulation.
A previously well 3½-month-old presents with poor feeding, diaphoresis during feeding, and poor growth. Vital signs reveal respirations of 70, pulse of 175, and blood pressure of 90/65 mm Hg in the upper and lower extremities. The cardiac examination reveals a palpable parasternal lift and a systolic thrill. A grade 4 holosystolic murmur and a mid-diastolic rumble are noted. The chest radiograph reveals cardiomegaly. The most likely diagnosis is
- A. cardiomyopathy
- B. myocarditis
- C. VSD
- D. coarctation of the aorta
Correct Answer: C
Rationale: The presentation suggests a large ventricular septal defect (VSD) causing significant left-to-right shunting and heart failure.
A 12-year-old child whose weight and body mass index (BMI) are in the 75th percentile has a diastolic blood pressure that is between the 95th and 99th percentiles for age, sex, and height on three separate occasions. Which test will be prescribed for this child initially?
- A. complete blood count
- B. erythrocyte sedimentation rate
- C. urinalysis and electrolytes
- D. renal function
Correct Answer: C
Rationale: Since the majority of children with stage 1 or 2 hypertension have renal or renovascular causes for elevated BP, renal function and plasma renin tests should be performed.