Nokea
How would the nurse caring for an infant with congestive heart failure (CHF) modify feeding techniques to adapt for the child's weakness and fatigue? (Select all that apply.)
- A. Feeding more frequently with smaller feedings
- B. Using a soft nipple with enlarged holes
- C. Holding and cuddling the child during feeding
- D. Substituting glucose water for formula
Correct Answer: A
Rationale: Infants with CHF fatigue easily. Feeding can be given more frequently in smaller amounts through a soft, large-holed nipple. Formulas with a denser caloric content can be offered. The child may be encouraged to nurse if he or she is held.
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The following are associated with an increased risk of fetal abnormalities:
- A. Oligohydramnios
- B. A previous sibling with anencephaly
- C. Paternal diabetes
- D. Decreased a-fetoprotein level
Correct Answer: B
Rationale: A previous sibling with anencephaly increases the risk of fetal abnormalities, particularly neural tube defects, in subsequent pregnancies.
An asymptomatic 45-year old male with newly diagnosed atrial fibrillation and normal echo, refused cardioversion while suggested. The next optimal management strategy for him is
- A. Sedate and cardiovert against patient wishes
- B. Aspirin
- C. Anticoagulation
- D. Rate control
Correct Answer: D
Rationale: Rate control is the optimal management strategy for asymptomatic atrial fibrillation when cardioversion is refused.
A 2-month-old male presents with tachycardia, dyspnea, tachypnea, and a gallop rhythm with no heart murmur. He was perfectly well until 1 day prior to the episode. The physical examination reveals a heart rate of 235, a temperature of 37.8°C, and a normal blood pressure with warm, well-perfused extremities. The most likely diagnosis is
- A. sepsis
- B. supraventricular tachycardia
- C. ingestion
- D. ventricular tachycardia
Correct Answer: B
Rationale: Supraventricular tachycardia can cause rapid heart rates and heart failure in infants.
What FOUR other features may you find on her physical examination if you suspect infective endocarditis?
- A. Intracranial hemorrhage
- B. Conjunctival hemorrhages
- C. Glomerulonephritis
- D. Roth spots
Correct Answer: D
Rationale: These physical signs are common in infective endocarditis and help with clinical diagnosis.
Tall (>25 mm), narrow, and spiked P waves are seen in
- A. Ebstein anomaly
- B. ventricular septal defect
- C. patent ductus arteriosus
- D. severe mitral stenosis
Correct Answer: D
Rationale: Severe mitral stenosis can cause tall, narrow, and spiked P waves due to left atrial enlargement.