The nurse is monitoring an infant with a congenital heart disease closely for signs of heart failure. Which early sign should the nurse be most concerned about?
- A. Pallor
- B. Cough
- C. Tachycardia
- D. Slow and shallow breathing
Correct Answer: C
Rationale: Tachycardia is an early sign of heart failure in infants because the heart attempts to compensate for decreased cardiac output by increasing the heart rate.
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Hereditary angioneurotic oedema (HANE):
- A. Deficiency of CI esterase occurs
- B. Can present as recurrent abdominal pain
- C. C4 is increased
- D. Androgen agonists are helpful in management
Correct Answer: A
Rationale: Deficiency of CI esterase occurs
What is cardiac power output (CPO) in a patient with acute anterior wall ST-elevation myocardial infarction and left ventricular failure? His mean arterial pressure was 60 mm Hg and cardiac output calculated on echo was 2.91l min−1.
- A. 0.48
- B. 0.38
- C. 0.58
- D. 0.68
Correct Answer: C
Rationale: Cardiac power output is calculated as (MAP × cardiac output) / 451. For the given values, the correct calculation gives a value of 0.58.
The patient most probably has
- A. severe aortic stenosis
- B. patent ductus arteriosus
- C. Williams syndrome
- D. none of the above
Correct Answer: A
Rationale: The clinical features suggest severe aortic stenosis with left ventricular hypertrophy.
Which is the incorrect statement regarding effect of dobutamine infusion in patients with heart failure
- A. Left ventricular end diastolic pressure decreases
- B. Mean arterial pressure decreases slightly due to interplay of actions on alpha 1 and alpha 2 receptors
- C. Left ventricular end systolic volume decreases
- D. There is increased myocardial oxygen demand
Correct Answer: B
Rationale: Mean arterial pressure typically increases, not decreases, with dobutamine infusion due to its inotropic effects.
Factors triggering renin stimulation:
- A. Hyponatraemia
- B. ACTH
- C. Hypovolaemia
- D. ANP
Correct Answer: C
Rationale: Hypovolaemia