Nokea
Pulmonary venous hypertension is a feature of
- A. Large ostium secundum defect with left to right shunt
- B. large ventricular septal defect with left to right shunt
- C. large pulmonary arteriovenous malformation
- D. Tricuspid atresia with restrictive atrial septal defect
Correct Answer: B
Rationale: Pulmonary venous hypertension is a feature of large ventricular septal defect with left to right shunt.
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Regarding cafe-au-lait spots:
- A. They can be normal findings
- B. They are found in tuberous sclerosis
- C. When present in a child, > 4 spots each > 0.5 cm, is diagnostic of neurofibromatosis type II
- D. Typical appearance in neurofibromatosis is of a smooth border
Correct Answer: A
Rationale: Cafe-au-lait spots can be a normal variant and do not always indicate an underlying pathology.
The nurse is caring for a school-age child who has had a cardiac catheterization. The child tells the nurse that the bandage is “too wet.†The nurse finds the bandage and bed soaked with blood. What is the priority nursing action?
- A. Notify physician
- B. Apply new bandage with more pressure
- C. Place the child in Trendelenburg position
- D. Apply direct pressure above catheterization site
Correct Answer: D
Rationale: If bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the percutaneous skin site to localize pressure over the vessel puncture. Notifying a physician and applying a new bandage can be done after pressure is applied. The nurse can have someone else notify the physician while the pressure is being maintained. It is not a helpful intervention to place the girl in the Trendelenburg position. It would increase the drainage from the lower extremities.
The jugular venous pressure (JVP) has a predictable relationship with pulmonary artery wedge pressure (PAWP). A JVP of >12 mm Hg predicted PAWP >22 mm Hg by 88% in which of the following trials?
- A. BNP
- B. ESCAPE
- C. EVEREST
- D. EMPA REG
Correct Answer: B
Rationale: The ESCAPE trial studied the effectiveness of therapies in patients with advanced heart failure and showed that elevated JVP was correlated with high pulmonary artery wedge pressures.
Dubowitz criteria to assess gestational age include:
- A. Skin colour
- B. Breast tissue
- C. Popliteal angle
- D. Moro reflex
Correct Answer: B
Rationale: Breast tissue is one of the criteria used in the Dubowitz assessment to estimate gestational age. Skin colour, popliteal angle, and Moro reflex are not part of the Dubowitz criteria.
Common causes of recurrent haematuria are:
- A. Berger's disease
- B. Goodpasture's syndrome
- C. Renal stones
- D. Acute post-streptococcal glomerulonephritis
Correct Answer: A
Rationale: The correct answer is A because Berger's disease (IgA nephropathy) is a common cause of recurrent haematuria. The other options (b-e) are less common or present differently.