Nokea
The initial treatment of choice for a symptomatic patient with isolated pulmonic stenosis is
- A. closed surgical blade valvotomy
- B. open surgical valvotomy
- C. balloon catheter valvuloplasty
- D. Blalock-Taussig shunt
Correct Answer: C
Rationale: Balloon catheter valvuloplasty is less invasive and effective for relieving pulmonic stenosis.
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Causes of pancytopenia and splenomegaly include:
- A. Low-grade non-Hodgkin's lymphoma
- B. Gaucher's disease
- C. Alcoholic cirrhosis
- D. BI2 deficiency
Correct Answer: B
Rationale: Gaucher's disease, a lysosomal storage disorder, can cause pancytopenia and splenomegaly due to bone marrow infiltration and hypersplenism.
What does the nurse need to assess first when caring for a child with a suspected myocardial infarction?
- A. Blood pressure and heart rate
- B. Chest pain and anxiety levels
- C. Oxygen saturation and respiratory rate
- D. Electrocardiogram and heart sounds
Correct Answer: D
Rationale: The first priority in a suspected myocardial infarction is to assess the heart's electrical activity using an electrocardiogram and listen to heart sounds for any abnormality such as murmurs.
During a routine well child exam on a 5-year-old child, a grade II/VI, harsh, late systolic ejection murmur at the upper left sternal border that transmits to both lung fields is auscultated. The child has normal growth and development. What will the nurse practitioner suspect?
- A. Aortic stenosis (AS)
- B. Patent ductus arteriosus (PDA)
- C. Pulmonic stenosis
- D. Tricuspid atresia
Correct Answer: C
Rationale: Pulmonic stenosis may be asymptomatic with a murmur as described above.
Which intervention should the nurse plan to decrease cardiac demands in an infant with congestive heart disease (CHD)?
- A. Organize nursing activities to allow for uninterrupted sleep.
- B. Allow the infant to sleep through feedings during the night.
- C. Wait for the infant to cry to show definite signs of hunger.
- D. Discourage parents from rocking the infant.
Correct Answer: A
Rationale: The infant requires rest and conservation of energy for feeding. Every effort is made to organize nursing activities to allow for uninterrupted periods of sleep. Whenever possible, parents are encouraged to stay with their infant to provide the holding, rocking, and cuddling that help children sleep more soundly. To minimize disturbing the infant, changing bed linens and complete bathing are done only when necessary. Feeding is planned to accommodate the infant’s sleep and wake patterns. The child is fed at the first sign of hunger, such as when sucking on fists, rather than waiting until he or she cries for a bottle because the stress of crying exhausts the limited energy supply. Because infants with CHD tire easily and may sleep through feedings, smaller feedings every 3 hours may be helpful.
A heart transplant may be indicated for a child with severe heart failure and:
- A. Patent ductus arteriosus (PDA)
- B. Ventricular septal defect (VSD)
- C. Hypoplastic left heart syndrome
- D. Pulmonic stenosis (PS)
Correct Answer: C
Rationale: Hypoplastic left heart syndrome is treated by procedures such as the Norwood procedure or heart transplant.