Nokea
Superior axis in ECG seen in
- A. AV canal defects
- B. Ebstein anomaly
- C. Tricuspid atresia
- D. Single ventricle
Correct Answer: B
Rationale: Ebstein's anomaly causes superior axis deviation on ECG.
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Which patient could require feeding by gavage?
- A. Infant with congestive heart failure (CHF)
- B. Toddler with repair of transposition of the great vessels
- C. Toddler with Kawasaki disease (KD) in the acute phase
- D. School-age child with rheumatic fever (RF) and chorea
Correct Answer: B
Rationale: Feeding by gavage may be required if the child is unable to feed orally without increased cardiac demand, as might be seen after surgical repair of transposition of the great vessels.
Regarding immunoglobins:
- A. IgG2 concentrations increase with age
- B. IgD is useful in mediating the late features of allergic reactions
- C. IgG2 subclass deficiency is associated with IgA deficiency
- D. IgM is complement-fixing antibody
Correct Answer: D
Rationale: IgM is complement-fixing antibody
The differential diagnosis of the patient includes all of the following EXCEPT
- A. rheumatic fever
- B. SLE
- C. chronic atrial fibrillation
- D. postmeningococcal immune complexes
Correct Answer: C
Rationale: Chronic atrial fibrillation is unlikely in an 8-year-old with acute onset symptoms.
Following surgical repair of the bladder, a female client is being discharged from the hospital to home with an indwelling urinary catheter. Which instruction is most important for the nurse to provide to this client?
- A. Avoid coiling the tubing and keep if free of kinks
- B. Cleanse the perineal area with soap and water twice daily
- C. Keep the drainage bag lower than the level of the bladder
- D. Drink 1,000 ml of fluids daily to irrigate catheter
Correct Answer: C
Rationale: Keeping the drainage bag lower than the bladder prevents backflow of urine, reducing the risk of infection.
A 12-month-old child who had repair of a congenital heart defect at 8 months of age has a normal exam and is not taking any medications. The nurse practitioner will contact the child's cardiologist to discuss whether the child needs which medication?
- A. Amoxicillin
- B. Capoten
- C. Digoxin
- D. Furosemide
Correct Answer: A
Rationale: Children who have had complete repair of congenital heart defect (CHD) should have subacute bacterial endocarditis (SBE) prophylaxis with amoxicillin for 6 months after the procedure.