Nokea
The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, “Why do my child’s fingertips look like that?†On what understanding does the nurse base a response?
- A. Clubbing occurs as a result of untreated congestive heart failure.
- B. Clubbing occurs as a result of a left-to-right shunting of blood.
- C. Clubbing occurs as a result of decreased cardiac output.
- D. Clubbing occurs as a result of chronic hypoxia.
Correct Answer: D
Rationale: Clubbing of the fingers develops in response to chronic hypoxia.
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Psychosis in children is suggested by:
- A. Absence of speech
- B. Intense outbursts of temper
- C. Recurrence of bed-wetting following a period of control
- D. Feelings of depersonalisation
Correct Answer: D
Rationale: Feelings of depersonalisation are a hallmark of psychosis. Absence of speech and temper outbursts are nonspecific, and bed-wetting is not diagnostic.
The patient experiences a headache and is unable to move the left side of his body. The most likely cause is
- A. embolic stroke
- B. cerebral thrombosis
- C. cerebral abscess
- D. moyamoya disease
Correct Answer: A
Rationale: Embolic stroke is a common complication of cyanotic congenital heart disease.
Recognised features of brucellosis include:
- A. Osteomyelitis
- B. Liver granuloma
- C. Pericarditis
- D. Splenomegaly
Correct Answer: D
Rationale: Splenomegaly
A 16-year-old being treated for hypertension has laboratory values of: Hemoglobin: 16 g/dL Hematocrit: 43% Sodium: 139 mEq/L Potassium: 4.4 mEq/L Total cholesterol: 220 mg/dL Which drug does the nurse suspect the patient takes based on the total cholesterol?
- A. Beta blockers
- B. Calcium channel blockers
- C. ACE inhibitors
- D. Diuretics
Correct Answer: A
Rationale: Beta blockers are used with caution in patients with hyperlipidemia, hyperglycemia, and impotence.
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.