Varying intensity of the first heart sound from a booming (bruit de canon) to virtual inaudibility is seen in which of the following?
- A. Mitral stenosis with atrial fibrillation
- B. Constant 2:1 AV block
- C. First-degree AV block
- D. Congenital complete heart block
Correct Answer: A
Rationale: In mitral stenosis with atrial fibrillation, the intensity of the first heart sound can vary depending on the dynamics of atrial contraction and ventricular filling.
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Regarding ECG in infancy
- A. T Wave inversion present
- B. PR interval is < 0.16 s
- C. P wave is < 3mm tall
- D. QRS represent ventricular depolarization
Correct Answer: B
Rationale: In infants, the PR interval is shorter than in adults (< 0.16 seconds).
After the nurse provides dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching?
- A. “Well follow these instructions until our child’s symptoms disappear.â€
- B. “Our child must maintain these dietary restrictions until adulthood.â€
- C. “Our child must maintain these dietary restrictions lifelong.â€
- D. “We’ll follow these instructions until our child has completely grown and developed.â€
Correct Answer: C
Rationale: Celiac disease requires lifelong adherence to a gluten-free diet to prevent symptoms and complications.
A seizure episode may be mimicked by:
- A. Breath-holding episode
- B. Choreoathetosis
- C. Hysterical reactions
- D. Vasovagal attack
Correct Answer: A
Rationale: Breath-holding episodes in children can mimic seizures due to transient loss of consciousness, often triggered by emotional stress or pain.
The following cardiac lesions are at increased risk for bacterial endocarditis EXCEPT
- A. mitral insufficiency
- B. aortic stenosis
- C. atrial septal defect seccundum
- D. coarctation of the aorta
Correct Answer: C
Rationale: ASD seccundum is generally not considered a high-risk lesion for bacterial endocarditis.
For the child with hypoplastic left heart syndrome, which medication may be given to keep the patent ductus arteriosus (PDA) open until surgery can be done?
- A. Prostaglandin E
- B. Indomethicin
- C. Ibuprofen
- D. Digoxin
Correct Answer: A
Rationale: Prostaglandin E is used to keep the PDA open in infants with hypoplastic left heart syndrome, allowing for adequate blood flow until surgical intervention can be performed.