An infant with congestive heart failure is receiving digoxin (Lanoxin). What does the nurse recognize as a sign of digoxin toxicity?
- A. Restlessness
- B. Decreased respiratory rate
- C. Increased urinary output
- D. Vomiting
Correct Answer: D
Rationale: Symptoms of digoxin toxicity include nausea, vomiting, anorexia, irregularity in pulse rate and rhythm, and a sudden change in pulse.
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Measuring serum potassium is essential in a child with confirmed hypertension because hyperkalemia may be seen in
- A. Liddle syndrome
- B. Gordon syndrome
- C. glucocorticoid remediable aldosteronism
- D. apparent mineralocorticoid excess
Correct Answer: D
Rationale: Hyperkalemia is not typically associated with Liddle syndrome, which causes hypokalemia.
Renin:
- A. Is secreted mainly in extrarenal tissues
- B. Secretion increases on lying supine
- C. Secretion increases with potassium
- D. Converts angiotensin I into angiotensin II
Correct Answer: D
Rationale: Renin is an enzyme produced by the kidneys that converts angiotensin I into angiotensin II which plays a key role in regulating blood pressure and fluid balance. The other options are incorrect because renin is not mainly secreted in extrarenal tissues its secretion does not increase on lying supine or with potassium and it does not regulate osmolality.
Mycoplasma pneumonia:
- A. Is associated with bullous myringitis
- B. Cold haemaglutinin antibodies are a recognised finding
- C. Guillain-Barre syndrome is a recognised sequel
- D. Is associated with erythema marginatum
Correct Answer: B
Rationale: Cold haemagglutinin antibodies are a recognized finding in Mycoplasma pneumonia. Bullous myringitis and Guillain-Barre syndrome are also associated.
Despite the use of antibiotic agents, mortality remains high, in the range of 20-25%. Serious morbidity occurs in 50-60% of children with documented infective endocarditis. Of the following, the MOST common morbidity is
- A. heart failure
- B. pulmonary emboli
- C. mycotic aneurysms
- D. acquired ventricular septal defect
Correct Answer: A
Rationale: Heart failure is the most common morbidity in children with infective endocarditis.
What is the priority nursing action for a child who is post-operative following a tonsillectomy?
- A. Provide pain management.
- B. Encourage fluid intake.
- C. Monitor for signs of bleeding.
- D. Educate the child about proper oral hygiene.
Correct Answer: C
Rationale: The priority after a tonsillectomy is to monitor for bleeding, as this can be a serious complication.
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