Nokea
Indications for surgical closure of a VSD include the following EXCEPT
- A. patients who cannot thrive
- B. patients whose symptoms cannot be controlled between 6 and 24 months
- C. patients with pulmonary vascular disease
- D. patients older than 2 years with a large VSD associated with a Qs ratio greater than 2:1
Correct Answer: C
Rationale: Surgical closure is not routinely indicated for all VSDs, especially if asymptomatic.
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All of the following are true regarding proximal renal tubular acidosis, except
- A. Growth failure in the first few years of life is a characteristic presentation
- B. Urine pH cannot be reduced to < 5.5
- C. It is usually a component of Fanconi syndrome
- D. Non-anion gap metabolic acidosis is common
Correct Answer: D
Rationale: Proximal renal tubular acidosis is associated with a normal anion gap metabolic acidosis, not a non-anion gap metabolic acidosis.
A nurse cares for a client who has an 80% blockage of the right coronary artery (RCA) and is scheduled for bypass surgery. Which intervention should the nurse be prepared to implement while this client waits for surgery?
- A. Administration of IV furosemide (Lasix)
- B. Initiation of an external pacemaker
- C. Assistance with endotracheal intubation
- D. Placement of central venous access
Correct Answer: B
Rationale: An 80% blockage of the RCA can lead to bradycardia or heart block. An external pacemaker may be needed to maintain adequate heart rate and cardiac output.
The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parent asks the nurse, 'How does Kawasaki disease affect my child's heart and blood vessels?' On what understanding is the nurse's response based?
- A. Inflammation weakens blood vessels, leading to aneurysm.
- B. Increased lipid levels lead to the development of atherosclerosis.
- C. Untreated disease causes mitral valve stenosis.
- D. Altered blood flow increases cardiac workload with resulting heart failure.
Correct Answer: A
Rationale: Inflammation of vessels weakens the walls of the vessels and often results in aneurysm.
Acute laryngotracheobronchitis in children:
- A. Needs to be treated by broad-spectrum antibiotics
- B. Humidified oxygen by tent needs to be administered in infancy
- C. Dexamethasone is known to shorten the duration of illness
- D. Adrenaline by nebuliser is absolutely contraindicated
Correct Answer: C
Rationale: Dexamethasone, a corticosteroid, is known to reduce inflammation and shorten the duration of illness in acute laryngotracheobronchitis (croup).
Which assessment indicates that the parent of a 7-year-old is following the prescribed treatment for congestive heart failure (CHF)?
- A. HR of 56 beats per minute
- B. Elevated red blood cell count
- C. 50th percentile height and weight for age
- D. Urine output of 0.5 cc/kg/hr
Correct Answer: C
Rationale: Normal growth (50th percentile) indicates good nutrition and overall health, suggesting that CHF is well controlled.