Nokea
Of the following, the MOST common clinical sign of coarctation of the aorta in older children is
- A. cardiac enlargement
- B. notching of the inferior border of the ribs
- C. a systolic ejection click or thrill in the suprasternal notch
- D. differential blood pressure: arms > legs
Correct Answer: B
Rationale: Notching of the ribs due to collateral circulation is a classic sign of coarctation of the aorta.
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The following syndromes are due to chromosomal abnormalities:
- A. Cri-du-chat syndrome
- B. Kearns-Sayre syndrome
- C. Marfan's syndrome
- D. Turner's syndrome
Correct Answer: D
Rationale: Turner's syndrome: Turner's syndrome is caused by a monosomy of the X chromosome (45,X), leading to characteristic features such as short stature and ovarian insufficiency.
Which clinical manifestation should the nurse expect to see as shock progresses in a child and becomes decompensated shock?
- A. Thirst
- B. Irritability
- C. Apprehension
- D. Confusion and somnolence
Correct Answer: D
Rationale: Confusion and somnolence are beginning signs of decompensated shock. Thirst, irritability, and apprehension are signs of compensated shock.
What is the primary nursing intervention to prevent bacterial endocarditis?
- A. Institute measures to prevent dental procedures.
- B. Counsel parents of high-risk children about prophylactic antibiotics.
- C. Observe children for complications, such as embolism and heart failure.
- D. Encourage restricted mobility in susceptible children.
Correct Answer: B
Rationale: The objective of nursing care is to counsel the parents of high-risk children about both the need for prophylactic antibiotics for dental procedures and the necessity of maintaining excellent oral health. The child’s dentist should be aware of the child’s cardiac condition. Dental procedures should be done to maintain a high level of oral health. Prophylactic antibiotics are necessary. Children should be observed for complications such as embolism and heart failure and restricted mobility should be encouraged in susceptible children, but maintaining good oral health and prophylactic antibiotics is important.
Galactosaemia:
- A. Exhibits autosomal recessive inheritance
- B. Is associated with cataracts
- C. Results in a low glucose level
- D. Is due to an inability to convert galactose into glucose
Correct Answer: A
Rationale: Galactosaemia is an autosomal recessive disorder. It is associated with cataracts and results from the inability to convert galactose into glucose.
While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?
- A. Decreased platelet count
- B. Polycythemia
- C. Decreased ferritin level
- D. Shift to the left
Correct Answer: B
Rationale: Chronic hypoxemia in CHD leads to polycythemia as a compensatory mechanism.