Nokea
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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All of the following are true regarding intussusception in children, except
- A. It is more common in boys than girls
- B. Adeno virus C has been implicated
- C. Urgent barium meal follow-through is the investigation of choice
- D. Postoperative intussusception is commonly ileoileal
Correct Answer: C
Rationale: Urgent barium meal follow-through is not the investigation of choice for intussusception; ultrasound is preferred for diagnosis.
A client admitted to a surgical unit is being evaluated for an intestinal obstruction. The healthcare provider prescribes a nasogastric tube (NGT) to be inserted and placed to intermittent low wall suction. Which intervention should the nurse implement to facilitate proper tube placement?
- A. Soak nasogastric tube in warm water
- B. Insert tube with client's head tilted back
- C. Apply suction while inserting tube
- D. Elevate head of bed 60 to 90 degrees
Correct Answer: D
Rationale: Elevating the head of the bed helps facilitate proper placement of the NGT and reduces the risk of aspiration.
Can parents hold their child during an echocardiogram procedure?
- A. You will be able to hold your child during the procedure.
- B. Your child can be active during the procedure, but can’t sit in your lap.
- C. Your child must lie quietly; sometimes a mild sedative is administered before the procedure.
- D. The procedure is invasive so your child will be restrained during the echocardiogram.
Correct Answer: C
Rationale: Although an echocardiogram is noninvasive, painless, and associated with no known side effects, it can be stressful for children. The child must lie quietly in the standard echocardiographic positions; crying, nursing, or sitting up often leads to diagnostic errors or omissions. Therefore, infants and young children may need a mild sedative; older children benefit from psychological preparation for the test. The distraction of a video or movie is often helpful.
The following syndromes are caused by chromosomal abnormalities:
- A. Cri-du-chat syndrome
- B. Kearns-Sayre syndrome
- C. Marfan's syndrome
- D. Turner's syndrome
Correct Answer: D
Rationale: Turner's syndrome: Turner's syndrome is caused by a monosomy of the X chromosome, characterized by short stature, infertility, and heart defects.
Aspirin has been ordered for the child with rheumatic fever (RF) in order to:
- A. Keep the patent ductus arteriosus (PDA) open
- B. Reduce joint inflammation
- C. Decrease swelling of strawberry tongue
- D. Treat ventricular hypertrophy of endocarditis
Correct Answer: B
Rationale: Aspirin helps alleviate the joint inflammation and pain experienced in RF.