Nokea
In which congenital heart defect (CHD) would the nurse need to take upper and lower extremity BPs?
- A. Transposition of the great vessels
- B. Aortic stenosis (AS)
- C. Coarctation of the aorta (COA)
- D. Tetralogy of Fallot (TOF)
Correct Answer: C
Rationale: COA causes increased blood pressure and strong pulses in the upper extremities with lower-than-expected BP and weak pulses in the lower extremities.
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Polycythaemia:
- A. Is a common cause of jaundice in the newborn
- B. Is significant if haematocrit > 65% on a capillary sample
- C. May cause apnoeas
- D. Exchange transfusion is the treatment of choice in symptomatic cases
Correct Answer: B
Rationale: Polycythaemia is considered significant if the haematocrit exceeds 65% on a capillary sample, as it can lead to hyperviscosity and related complications.
What are FOUR possible differential diagnoses associated with aortopathy in a child, aside from Marfan’s?
- A. Ehlers-Danlos Syndrome (vascular type IV)
- B. Bicuspid aortic valve
- C. Takayasu Arteritis
- D. Unrepaired coarctation of the aorta
Correct Answer: A
Rationale: These are potential differential diagnoses associated with aortopathy in children, aside from Marfan’s syndrome, which is a common condition linked to aortic dilation.
Atypical hemolytic uremic syndrome is associated with
- A. Factor VII deficiency
- B. Factor H deficiency
- C. Interleukin 10 deficiency
- D. Properdin deficiency
Correct Answer: B
Rationale: Factor H deficiency is a known cause of atypical hemolytic uremic syndrome.
An adult female with multiple sclerosis (MS) falls while walking to the bathroom. On transfer to the intensive care unit, she is confused and has had projectile vomiting twice. Which intervention should the nurse implement first?
- A. Determine client's last dose of corticosteroids
- B. Determine neurological baseline prior to the fall
- C. Administer a PRN IV antiemetic as prescribed
- D. Complete head to toe neurological assessment.
Correct Answer: D
Rationale: The symptoms suggest increased intracranial pressure or a neurological emergency. A thorough neurological assessment is necessary to identify the cause and guide further interventions.
Surgical repair of VSD should be considered at the time of diagnosis
- A. small supracristal VSD
- B. VSD with heart failure
- C. hemodynamically restrictive VSD
- D. significant VSD
Correct Answer: B
Rationale: Significant or symptomatic VSDs warrant early surgical intervention.