Nokea
During a well-child checkup for an infant with tetralogy of Fallot (TOF), the child develops severe respiratory distress and becomes cyanotic. The nurse's first action should be to:
- A. Lay the child flat to promote hemostasis
- B. Lay the child flat with legs elevated to increase blood flow to the heart
- C. Sit the child on the parent's lap, with legs dangling, to promote venous pooling
- D. Hold the child in knee-chest position to decrease venous blood return
Correct Answer: D
Rationale: The knee-chest position increases systemic vascular resistance (SVR), which increases blood flow to the pulmonary artery.
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What associated manifestation might the nurse occasionally find in a child diagnosed with Wilms tumor?
- A. Atrial fibrillation
- B. Hypertension
- C. Endocarditis
- D. Hyperlipidemia
Correct Answer: B
Rationale: Wilms tumor, due to its location in the kidney, can be associated with secondary hypertension.
The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk exists of cerebrovascular accidents (strokes). Which is an important objective to decrease this risk?
- A. Minimize seizures
- B. Prevent dehydration
- C. Promote cardiac output
- D. Reduce energy expenditure
Correct Answer: B
Rationale: In children with persistent hypoxia, polycythemia develops. Dehydration must be prevented in hypoxemic children because it potentiates the risk of strokes. Minimizing seizures, promoting cardiac output, and reducing energy expenditure will not reduce the risk of cerebrovascular accidents.
Methaemoglobinaemia may occur as a result of ingestion or exposure to:
- A. Paraquat
- B. Methylene blue
- C. Potassium permanganate
- D. Nitrates
Correct Answer: D
Rationale: Nitrates, when ingested, can lead to methaemoglobinaemia by converting hemoglobin to methemoglobin, impairing oxygen delivery.
What is the definition of a giant coronary artery aneurysm in Kawasaki Disease?
- A. ≥8 mm in diameter
- B. Z score ≥10
- C. Both A and B
- D. None of the above
Correct Answer: C
Rationale: A giant coronary artery aneurysm in Kawasaki Disease is defined by either a diameter of ≥8 mm or a Z score ≥10, which indicates a significantly increased size.
All the following antimalarials act by forming heme complexes which are toxic to the parasite except
- A. Primaquine
- B. Chloroquine
- C. Mefloquine
- D. Quinidine
Correct Answer: A
Rationale: Primaquine does not act by forming heme complexes; it works through a different mechanism.