Nokea
The MOST common cause of syncope in children is
- A. Wolff-Parkinson-White syndrome
- B. prolonged QT syndrome
- C. atrioventricular block
- D. neurocardiogenic syncope
Correct Answer: D
Rationale: Neurocardiogenic syncope is the most common cause of syncope in children due to autonomic dysfunction.
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The school nurse has been following a child who frequently complains of dizziness and headache. Today, she is brought in after fainting in the cafeteria following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. The nurse suspects she has:
- A. Transposition of the great vessels
- B. Coarctation of the aorta (COA)
- C. Aortic stenosis (AS)
- D. Pulmonic stenosis (PS)
Correct Answer: B
Rationale: In older children, COA can cause elevated blood pressure, headache, fainting, and bounding radial pulses.
Ventricular tachycardia (VT) is defined as at least 3 premature ventricular contractions PVCs at >120 beats/min. Hemodynamically unstable patients with VT should be immediately treated with
- A. catheter ablation
- B. ICD implantation
- C. DC cardioversion
- D. amiodarone
Correct Answer: C
Rationale: DC cardioversion is the immediate treatment for hemodynamically unstable VT.
The nurse is finishing her shift on the pediatric unit. Because her shift is ending, which intervention takes top priority?
- A. Changing the linens on the clients’ beds
- B. Restocking the bedside supplies needed for a dressing change on the upcoming shift
- C. Documenting the care provided during her shift
- D. Emptying the trash cans in the assigned client room
Correct Answer: C
Rationale: Documenting care is a legal and professional responsibility that ensures continuity of care and accurate communication between shifts.
While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has:
- A. Pulmonary hypertension
- B. Patent ductus arteriosus (PDA)
- C. Ventricular septal defect (VSD)
- D. Bronchopulmonary dysplasia
Correct Answer: B
Rationale: A machine-like murmur is the hallmark of a PDA.
A pulmonary embolus occurring while the patient is on the combined oral contraceptive pill:
- A. Is more likely in anti-thrombin III deficiency
- B. Is more likely in protein C deficiency
- C. Is an absolute contraindication to the combined pill
- D. Is an increased risk in smokers
Correct Answer: A
Rationale: Anti-thrombin III deficiency increases the risk of thromboembolic events, including pulmonary embolism, especially in patients on the combined oral contraceptive pill.