Nokea
What are FIVE indications for pacemaker insertion in a child with congenital heart block?
- A. Symptomatic bradycardia
- B. Ventricular dysfunction or low cardiac output
- C. Wide QRS escape
- D. Complex ventricular ectopy
Correct Answer: A
Rationale: Symptomatic bradycardia is the most common indication for pacemaker insertion in children with congenital heart block, to ensure adequate heart rate and perfusion.
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Of the following, the cardiac lesion resulting in increased volume load is
- A. valvular pulmonic stenosis
- B. patent ductus arteriosus
- C. valvular aortic stenosis
- D. mitral stenosis
Correct Answer: B
Rationale: Patent ductus arteriosus leads to increased volume load on the left side of the heart.
Type I renal tubular acidosis:
- A. Only occurs in children
- B. Is caused by a failure of ammonium ion secretion
- C. Is associated with renal calcification
- D. Typically leads to hypovolaemia
Correct Answer: B
Rationale: Type I renal tubular acidosis is characterized by a failure in ammonium ion secretion, leading to a failure to acidify urine, which can result in metabolic acidosis.
During play, a toddler with a history of tetralogy of Fallot (TOF) might assume which position?
- A. Sitting
- B. Supine
- C. Squatting
- D. Standing
Correct Answer: C
Rationale: Squatting naturally increases SVR by occluding venous return from the lower extremities, thereby increasing pulmonary blood flow.
What should the nurse assess prior to administering digoxin? (Select all that apply.)
- A. Sclera
- B. Apical pulse rate
- C. Cough
- D. Liver function test
Correct Answer: B
Rationale: Because digoxin decreases the heart rate, the apical pulse should be assessed. If the HR is below 60 beats per minute, digoxin should not be administered.
Regarding intussusception in childhood:
- A. Incidence is most common in children over 3 years of age
- B. Barium enema is the investigation of choice
- C. Patient commonly presents with constant abdominal pain
- D. It is associated with Henoch-Schoenlein purpura
Correct Answer: D
Rationale: Intussusception is associated with Henoch-Schoenlein purpura, a condition that can cause inflammation and bleeding in the small blood vessels.