The MOST common cause of pulmonary hypertension in pediatric patients is
- A. idiopathic pulmonary hypertension
- B. pulmonary venoocclusive disease
- C. left-sided valvular heart disease
- D. chronic obstructive pulmonary disease
Correct Answer: A
Rationale: Idiopathic pulmonary hypertension is a rare but recognized cause of pulmonary hypertension in children.
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Concerning insulin-dependent diabetes mellitus in children:
- A. Microangiopathic changes are rare before puberty
- B. Isophane is shorter acting than soluble insulin
- C. Lipohypertrophy is more common than lipo-atrophy
- D. Fructosamine can be used to monitor glucose control
Correct Answer: A
Rationale: Microangiopathic changes are indeed rare before puberty in children with insulin-dependent diabetes mellitus. Isophane is not shorter acting than soluble insulin, and fructosamine is used to monitor glucose control.
Among the following Group A beta hemolytic streptococcus has the highest resistance to
- A. Cephalexin
- B. Clindamycin
- C. Erythromycin
- D. Doxycycline
Correct Answer: C
Rationale: Group A beta hemolytic streptococcus has shown the highest resistance to erythromycin.
The nurse is caring for a child with a diagnosis of Kawasaki disease. The child’s parent asks the nurse, “How does Kawasaki disease affect my child’s heart and blood vessels?†On what understanding is the nurse’s response based?
- A. Inflammation weakens blood vessels, leading to aneurysm.
- B. Increased lipid levels lead to the development of atherosclerosis.
- C. Untreated disease causes mitral valve stenosis.
- D. Altered blood flow increases cardiac workload with resulting heart failure.
Correct Answer: A
Rationale: Inflammation of vessels weakens the walls of the vessels and often results in aneurysm.
SVT in children differ from physiologic sinus tachycardia by all the following EXCEPT
- A. sudden onset and termination
- B. persistent ventricular rate of >180 bpm
- C. fixed RR interval on ECG
- D. evident change in heart rate with activity
Correct Answer: D
Rationale: Physiologic sinus tachycardia can show changes in heart rate with activity, unlike SVT which has a fixed rate.
The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin (Lanoxin). Which statement by the parent indicates a need for further instruction?
- A. “If my child vomits after the medication administration, I will repeat the dose.â€
- B. “I will not mix the medication with food.â€
- C. “I will take my child’s pulse before administering the medication.â€
- D. “If more than one dose is missed, I will call the provider.â€
Correct Answer: A
Rationale: Repeating the dose after vomiting can lead to digoxin toxicity, which is dangerous. The parent should be instructed to contact the healthcare provider if vomiting occurs after administration.