Nokea
A wide splitting of S2 during expiration is auscultated in a 2-week-old infant.
- A. Atrial septal defect (ASD)
- B. Coarctation of the aorta (COA)
- C. Patent ductus arteriosis (PDA)
- D. Ventricular septal defect (VSD)
Correct Answer: A
Rationale: A wide splitting of S2 without becoming a single sound on expiration may indicate increased pulmonary flow, typical of atrial septal defect.
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Complications of long-term TPN administration are:
- A. Selenium deficiency
- B. Abnormal liver function tests
- C. Osteopaenia
- D. Renal failure
Correct Answer: A
Rationale: Selenium deficiency is a known complication of long-term total parenteral nutrition (TPN) due to inadequate trace element supplementation.
The most common cardiac dysrhythmia in pediatrics is:
- A. Ventricular tachycardia
- B. Sinus bradycardia
- C. Supraventricular tachycardia
- D. First-degree heart block
Correct Answer: C
Rationale: SVT is the most common dysrhythmia in children.
A child with rheumatic fever is being admitted to the pediatric floor. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever?
- A. “Has your child complained of back pain?â€
- B. “Has your child complained of headaches?â€
- C. “Has your child had any nausea or vomiting?â€
- D. “Did your child have a sore throat or fever within the last 2 months?â€
Correct Answer: D
Rationale: A history of sore throat or fever within the last 2 months is significant as rheumatic fever often follows a streptococcal infection such as strep throat.
An 8-year-old from the former Soviet Union is brought to your office because of a heart murmur and dusty blue skin. He has marked clubbing of his fingers and toes, and his hematocrit is 70%. He has a grade 4/6 holosystolic murmur. His chest x-ray reveals a normal pulmonary blood flow as well as a right-sided aortic arch. What is the likely diagnosis?
- A. total anomalous venous return
- B. tetralogy of Fallot
- C. Eisenmenger syndrome
- D. transposition of the great vessels
Correct Answer: C
Rationale: Eisenmenger syndrome involves reversal of shunt direction due to long-standing pulmonary hypertension, explaining the cyanosis and clubbing.
Cardiac catheterization therapeutic in
- A. Infundibular pulmonary stenosis
- B. Mitral regurgitation
- C. Aortic stenosis
- D. Transposition of great vessels
Correct Answer: A
Rationale: Infundibular pulmonary stenosis can be treated therapeutically with cardiac catheterization.