Nokea
Closure of the ductus will worsen following conditions
- A. Transposition of great vessels
- B. Tricuspid Atresia
- C. Hypoplastic Left heart syndrome
- D. Tetrology of Fallots
Correct Answer: C
Rationale: Closure of the ductus arteriosus worsens hypoplastic left heart syndrome by removing the only source of systemic circulation.
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Which finding would alert a nurse that a hospitalized 6-year-old child is at risk for a severe asthma exacerbation?
- A. Oxygen saturation of 95%
- B. Mild work of breathing
- C. Absence of intercostals or substernal retractions
- D. History of steroid-dependent asthma
Correct Answer: D
Rationale: A history of steroid-dependent asthma indicates severe asthma, increasing the risk of a life-threatening exacerbation.
Evidence of increased pulmonary flow is associated with:
- A. Coarctation of the aorta
- B. Fallot's tetralogy
- C. Pneumocystis infection
- D. Ventricular septal defect
Correct Answer: D
Rationale: A ventricular septal defect (VSD) leads to increased pulmonary blood flow due to left-to-right shunting, resulting in pulmonary congestion.
Elevated levels of CPK are seen in:
- A. Duchenne muscular dystrophy
- B. Dermatomyositis
- C. Spinal muscular atrophy
- D. Malignant hyperthermia
Correct Answer: A
Rationale: Duchenne muscular dystrophy: Elevated creatine phosphokinase (CPK) levels are a hallmark of Duchenne muscular dystrophy due to muscle damage and degeneration.
What is the age-predicted maximum heart rate in a 60-year old man on beta blockers?
- A. 122
- B. 133
- C. 155
- D. 166
Correct Answer: A
Rationale: Beta blockers reduce the maximum heart rate. The age-predicted maximum heart rate for a 60-year-old on beta blockers is approximately 122 bpm.
Paroxysmal hypercyanotic attacks (hypoxic, blue, or tet spells) are a particular problem during the lst 2 yr of life. They are characterized by
- A. early evening occurrence
- B. an increase in intensity of the systolic murmur
- C. unpredictable onset
- D. metabolic alkalosis
Correct Answer: A
Rationale: Unpredictable onset and metabolic alkalosis are common features of tet spells.