Nokea
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.
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The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is:
- A. It is always helpful to get a second opinion about any serious condition like this.
- B. Your baby's defect is small and will likely close on its own by 1 year of age.
- C. It is common for physicians to wait until an infant develops respiratory distress before they do the surgery.
- D. With a small defect like this, they wait until the child is 10 years old to do the surgery.
Correct Answer: B
Rationale: Most small VSDs close spontaneously within the first year of life.
A grade II vibratory, mid-systolic murmur at the mid sternal border in a 4-year-old child that is louder when the child is supine is most likely which type of murmur?
- A. Pathologic murmur
- B. Pulmonary flow murmur
- C. Still's murmur
- D. Venous hum
Correct Answer: C
Rationale: A Still's murmur is characterized by a vibratory or musical low-grade sound, along the sternal border, which is louder when the child is supine or during inspiration.
Nystagmus can be a presenting sign in:
- A. Partial albinism
- B. Retinopathy of prematurity
- C. Acute vestibulitis
- D. Medulloblastoma
Correct Answer: D
Rationale: Medulloblastoma, a type of brain tumor, can present with nystagmus due to its impact on the cerebellum and brainstem.
The following are recognised in coeliac disease:
- A. Oesophageal carcinoma
- B. Malignant lymphoma
- C. Hyposplenism
- D. Amyloidosis
Correct Answer: C
Rationale: Hyposplenism: Coeliac disease is associated with hyposplenism, which can result in impaired immune responses and increased susceptibility to infections.
Of the following, the cyanotic cardiac lesion with decreased pulmonary blood flow is
- A. transposition of the great vessels
- B. single ventricle
- C. truncus arteriosus
- D. tricuspid atresia
Correct Answer: D
Rationale: Tricuspid atresia results in decreased pulmonary blood flow due to lack of right ventricular input.