Nokea
The severity of symptoms of Ebstein anomaly and the degree of cyanosis are high and depend on the extent of
- A. displacement of the tricuspid valve
- B. cardiac dysrhythmias
- C. atrial right-to-left shunt
- D. pulmonary vascular resistance
Correct Answer: A
Rationale: Displacement of the tricuspid valve is a key determinant of symptom severity in Ebstein anomaly.
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The nurse is caring for a child who has undergone a cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurse's first action is to:
- A. Call the interventional cardiologist
- B. Notify the cardiac catheterization laboratory that the child will be returning
- C. Apply a bulky pressure dressing over the present dressing
- D. Apply direct pressure 1 inch above the puncture site
Correct Answer: D
Rationale: Direct pressure above the puncture site helps control bleeding by localizing pressure over the vessel.
Fluids are restricted to 1,500 ml daily for a male client with acute kidney injury (AKI). He is frustrated and complaining of constant thirst, and the nurse discovers that the family is providing the client with additional fluids. Which intervention should the nurse implement?
- A. Remove all sources of liquids from the client's room
- B. Allow family to give client a measured amount of ice chips
- C. Restrict family visiting until the client's condition is stable
- D. Provide the client with oral swabs to moisten his mouth
Correct Answer: D
Rationale: Oral swabs can help alleviate thirst without increasing fluid intake, which is restricted in AKI.
Appropriate investigations in the emergency management of a 4-year-old presenting in a coma:
- A. Serum magnesium level
- B. Throat swabs
- C. Arterial blood gas
- D. CT scan
Correct Answer: C
Rationale: Arterial blood gas analysis is crucial in the emergency management of a comatose child to assess oxygenation, ventilation, and acid-base status.
X-linked conditions include:
- A. Duchenne muscular dystrophy
- B. Hypophosphataemic rickets
- C. Huntington's chorea
- D. Phenylketonuria
Correct Answer: A
Rationale: Duchenne muscular dystrophy is an X-linked recessive disorder caused by mutations in the dystrophin gene.
A 6-month-old presents with tachycardia, tachypnea, and poor feeding for 3 months. Physical examination reveals a continuous machinery murmur and a wide pulse pressure with a prominent apical impulse. The most likely diagnosis is
- A. pulmonic stenosis
- B. aortic stenosis
- C. ventricular septal defect
- D. patent ductus arteriosus
Correct Answer: D
Rationale: Patent ductus arteriosus causes a continuous machinery murmur and wide pulse pressure.