Nokea
On examination, a nurse hears a murmur at the left sternal border (LSB) in a child with diarrhea and fever. The parent asks why the pediatrician never mentioned the murmur. The nurse explains:
- A. The pediatrician is not a cardiologist.
- B. Murmurs are difficult to detect, especially in children.
- C. The fever increased the intensity of the murmur.
- D. We need to refer the child to an interventional cardiologist.
Correct Answer: C
Rationale: The increased cardiac output associated with fever can accentuate a heart murmur, making it more noticeable.
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Pulsus paradoxus is associated with
- A. pericarditis
- B. endocarditis
- C. rheumatic fever
- D. myocarditis
Correct Answer: A
Rationale: Pulsus paradoxus is commonly associated with pericardial diseases such as constrictive pericarditis.
What are FOUR absolute contraindications for cardiac transplantation?
- A. Active infection
- B. Ongoing malignancy
- C. Medical non-compliance
- D. Drug abuse
Correct Answer: D
Rationale: These are absolute contraindications for cardiac transplantation due to the risks of infection, poor outcomes, and non-compliance.
The MOST common cause of death from associated cardiac lesions without heart syndrome in the first month of life is
- A. d-Transposition
- B. hypoplastic left heart syndrome
- C. pulmonary atresia
- D. truncus arteriosus
Correct Answer: A
Rationale: d-Transposition of the great arteries is a common cause of death in the first month due to mixing of oxygenated and deoxygenated blood.
What is accurate about the characteristics of high-density lipoproteins (HDLs)?
- A. They have high amounts of triglycerides.
- B. They have only small amounts of protein.
- C. They have little cholesterol.
- D. They aid in steroid production.
Correct Answer: C
Rationale: HDLs have low amounts of triglycerides, large amounts of proteins, low amounts of cholesterol, and are excreted via the liver. They have no role in the production of steroids.
A child has been diagnosed with valvular disease following rheumatic fever (RF). During patient teaching, the nurse discusses the child’s long-term prophylactic therapy with antibiotics for dental procedures, surgery, and childbirth. The parents Indicate they understand when they say:
- A. “She will need to take the antibiotics until she turns 18 years old.â€
- B. “She will need to take the antibiotics for 5 years after the last attack.â€
- C. “She will need to take the antibiotics for 10 years after the last attack.â€
- D. “She will need to take the antibiotics for the rest of her life.â€
Correct Answer: D
Rationale: Lifelong antibiotic prophylaxis is recommended for individuals with valvular disease following rheumatic fever to prevent recurrent infections and further cardiac damage.