Nokea
The primary care pediatric nurse practitioner is performing a well child examination on a school-age child who had complete repair of a tetralogy of Fallot (TOF) defect in infancy. What is important in this child's health maintenance regime?
- A. Cardiology clearance for sports participation
- B. Restriction of physical activity to avoid pulmonary complications
- C. Sub-acute bacterial endocarditis prophylaxis precautions
- D. Teaching about management of hypercyanotic episodes
Correct Answer: A
Rationale: Children who have had TOF repair must be cleared by cardiology before participation in sports.
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Mitral valve prolapse
- A. Occurs in congenital myxomatous valves
- B. Need a Sx
- C. Rare cause of MR
- D. Need prophylactic antibiotics
Correct Answer: A
Rationale: Mitral valve prolapse often occurs in congenital myxomatous valves.
Isovolumic contraction phase of ventricular systole occurs during which of the following phases of central venous pressure, approximately
- A. From nadir of y descent to peak of a wave
- B. From peak of a wave to trough of x wave
- C. From trough of x wave to peak of c wave
- D. From peak of c wave to trough of x' descent
Correct Answer: C
Rationale: Isovolumic contraction occurs from the trough of the x wave to the peak of the c wave.
What are FOUR possible causes of left axis deviation in a newborn with features of Trisomy 21?
- A. AVSD
- B. Tricuspid atresia
- C. Pulmonary atresia with intact ventricular septum
- D. Mechanical shift
Correct Answer: A
Rationale: AVSD is a common congenital heart defect associated with Trisomy 21 and can lead to left axis deviation seen on ECG.
An infant who has been in foster care since birth requires a blood transfusion. Who is authorized to give written, informed consent for the procedure?
- A. The foster mother
- B. The social worker who placed the infant in the foster home
- C. The registered nurse caring for the infant
- D. The nurse-manager
Correct Answer: A
Rationale: The foster mother, as the primary caregiver, is typically authorized to provide consent for medical procedures.
In a cyanotic spell of TOF
- A. Systemic vascular resistance is reduced
- B. Murmur disappear
- C. PO2 is reduced
- D. Right to Left shunt is Increased
Correct Answer: D
Rationale: During a cyanotic spell in Tetralogy of Fallot, there is an increased right-to-left shunting through the ventricular septal defect.