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Treatment for congestive heart failure (CHF) in an infant began 3 days ago and has included digoxin and furosemide. The child no longer has retractions, lungs are clear, and HR is 96 beats per minute while sleeping. The nurse is confident that the child has diuresed successfully and has good renal perfusion when the nurse notes the child's urine output is:
- A. 0.5 cc/kg/hr
- B. 1 cc/kg/hr
- C. 30 cc/hr
- D. 1 oz/hr
Correct Answer: B
Rationale: Normal pediatric urine output is approximately 1 cc/kg/hr.
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A cardiac catheterization of a client with heart disease indicates the following blockages: 95% proximal left anterior descending (LAD), 99% proximal circumflex, and ? % proximal right coronary artery (RCA). The client later asks the nurse 'what does all this mean for me?' What information should the nurse provide?
- A. Blood supply to the heart is diminished by atherosclerotic lesions, which necessitate lifestyle changes.
- B. Blood vessels supplying the pumping chamber have blockages indicating a past heart attack.
- C. Three main arteries have major blockages, with only 1 to 5% of blood flow getting through to the heart muscle.
- D. The heart is not receiving enough blood, so there is a risk of heart failure and fluid retention.
Correct Answer: C
Rationale: This explanation provides a clear understanding of the severity of the blockages and the implications for the client's heart function.
The following conditions can present in a newborn infant as a bullous eruption:
- A. Syphilis
- B. Mast cell disease
- C. Epidermolysis bullosa
- D. Phenylketonuria
Correct Answer: C
Rationale: Epidermolysis bullosa is a genetic condition causing blistering of the skin. Syphilis and mast cell disease can also cause bullous eruptions, but phenylketonuria does not.
Surgical repair of VSD should be considered at the time of diagnosis
- A. small supracristal VSD
- B. VSD with heart failure
- C. hemodynamically restrictive VSD
- D. significant VSD
Correct Answer: B
Rationale: Significant or symptomatic VSDs warrant early surgical intervention.
Avascular necrosis of the femoral head is associated with:
- A. Sickle cell trait
- B. Nephrotic syndrome
- C. Cushing's syndrome
- D. Hypothyroidism
Correct Answer: C
Rationale: Cushing's syndrome is associated with avascular necrosis due to steroid use. Sickle cell trait, nephrotic syndrome, and hypothyroidism are not directly linked.
How much bilirubin can be bound to 1 gm of albumin?
- A. 8.5 mg
- B. 9.8 mg
- C. 10.5 mg
- D. 13.6 mg
Correct Answer: A
Rationale: 1 gram of albumin can bind approximately 8.5 mg of bilirubin, which is important in managing neonatal jaundice.