Nokea
Of the following, the cyanotic cardiac lesion with decreased pulmonary blood flow is
- A. transposition of the great vessels
- B. single ventricle
- C. truncus arteriosus
- D. tricuspid atresia
Correct Answer: D
Rationale: Tricuspid atresia results in decreased pulmonary blood flow due to lack of right ventricular input.
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In statistical methodology:
- A. The median and mean are different when the population distribution is skewed
- B. Mode refers to the value that occurs with the highest frequency
- C. The value of 'r' (coefficient of variation) ranges from -1 to +1
- D. Incidence is defined as the number of cases seen in the population at any given period of time
Correct Answer: A
Rationale: The median and mean differ in skewed distributions because the mean is influenced by extreme values, while the median is not.
Nurse Mariane is caring for an infant with spina bifida. Which technique is most important in recognizing possible hydrocephalus?
- A. Measuring head circumference
- B. Obtaining skull X-ray
- C. Performing a lumbar puncture
- D. Magnetic resonance imaging (MRI)
Correct Answer: A
Rationale: Measuring head circumference is a non-invasive way to monitor for hydrocephalus, a common complication of spina bifida.
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.
Increased fetal haemoglobin is seen in:
- A. Haemoglobin H disease
- B. β-thalassaemia major
- C. Fanconi's anaemia
- D. Pyruvate kinase deficiency
Correct Answer: B
Rationale: Increased fetal haemoglobin (HbF) is a compensatory mechanism in β-thalassaemia major to counteract the reduced production of adult haemoglobin (HbA).
Which therapeutic management should the nurse expect to implement for a child with rheumatic fever?
- A. Administering penicillin
- B. Avoiding salicylates (aspirin)
- C. Imposing strict bed rest for 4 to 6 weeks
- D. Administering corticosteroids if chorea develops
Correct Answer: A
Rationale: The goal of medical management is the eradication of the hemolytic streptococci. Penicillin is the drug of choice. Salicylates can be used to control the inflammatory process, especially in the joints, and reduce the fever and discomfort. Bed rest is recommended for the acute febrile stage, but it does not need to be strict. The chorea is transient and will resolve without treatment.