Nokea
Mechanisms of dyspnea in left heart disease include all, except
- A. PVH and decreased lung compliance
- B. Respiratory muscle fatigue
- C. Elevated LV End diastolic pressure leads to decreased antegrade coronary blood flow
- D. Reverse 'Bernheim' effect
Correct Answer: C
Rationale: Elevated LV end-diastolic pressure does not typically lead to decreased antegrade coronary blood flow.
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The child becomes unresponsive. The most likely underlying lesion is
- A. cardiomyopathy
- B. anomalous coronary artery
- C. tetralogy of Fallot
- D. constipation
Correct Answer: C
Rationale: Tetralogy of Fallot can cause hypoxic spells leading to unresponsiveness.
The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is:
- A. It is always helpful to get a second opinion about any serious condition like this.
- B. Your baby's defect is small and will likely close on its own by 1 year of age.
- C. It is common for physicians to wait until an infant develops respiratory distress before they do the surgery.
- D. With a small defect like this, they wait until the child is 10 years old to do the surgery.
Correct Answer: B
Rationale: Most small VSDs close spontaneously within the first year of life.
An 18-month-old with a myelomeningocele is undergoing a cardiac catheterization. The mother expresses concern about the use of dye in the procedure. The child does not have any allergies. In addition to an iodine allergy, which other allergy should the nurse bring to the attention of the catheterization staff?
- A. Soy
- B. Latex
- C. Penicillin
- D. Dairy
Correct Answer: B
Rationale: Children with spina bifida (myelomeningocele) are often allergic to latex; catheter balloons and other materials may contain latex.
All of the following immune-mediated diseases are associated with antineutrophil cytoplasmic antibody, except
- A. Wegener granulomatosis
- B. Churg-Strauss syndrome
- C. Microscopic polyangiitis
- D. Henoch-Schönlein purpura
Correct Answer: D
Rationale: Henoch-Schönlein purpura is not associated with antineutrophil cytoplasmic antibodies (ANCA); it is an IgA-mediated vasculitis.
Diagnostic signs of child abuse are:
- A. Sub-hyaloid bleeding
- B. Spiral fracture of a long bone
- C. Lacerated tongue
- D. Posterior rib fractures
Correct Answer: D
Rationale: Posterior rib fractures are highly suggestive of child abuse, as they are often caused by forceful squeezing or shaking.