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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Anthracycline (doxorubicin) on rare occasion causes acute inflammatory myocardial injury, but more classically results in dilated cardiomyopathy (DCM) in up to 30% of patients with a cumulative dose of doxorubicin exceeding
- A. 250 mg/m²
- B. 350 mg/m²
- C. 450 mg/m²
- D. 550 mg/m²
Correct Answer: D
Rationale: A cumulative dose of doxorubicin exceeding 550 mg/m² is associated with increased risk of dilated cardiomyopathy.
Pulmonary hypertension is a complication of:
- A. ASD
- B. Eisenmenger syndrome
- C. Tricuspid atresia
- D. Tricuspid regurgitation
Correct Answer: B
Rationale: Eisenmenger syndrome is a well-known cause of pulmonary hypertension. The other options (a-d) can also lead to pulmonary hypertension but are less specific.
Initial tests in a 2-year-old child with failure to thrive include:
- A. Thyroid function tests
- B. Sweat test
- C. Urine culture
- D. Colonoscopy
Correct Answer: B
Rationale: a sweat test is crucial for diagnosing cystic fibrosis, a common cause of failure to thrive in children. The other tests (a-d) are less specific and not typically first-line for this presentation.
An infant is hospitalized for treatment of nonorganic failure to thrive. Which nursing action is most appropriate for this infant?
- A. Encouraging the infant to hold a bottle
- B. Keeping the infant on bed rest to conserve energy
- C. Rotating caregivers to provide more stimulation
- D. Maintaining a consistent, structured environment
Correct Answer: D
Rationale: A consistent, structured environment helps build trust and security, which is essential for an infant with nonorganic failure to thrive.
Coarctation of aorta is:
- A. Commonly associated with Turner's syndrome
- B. Inherited as autosomal dominant
- C. Associated with intracranial aneurysms
- D. Excluded from the diagnosis in the presence of femoral pulses
Correct Answer: A
Rationale: Coarctation of the aorta is commonly associated with Turner's syndrome, a chromosomal condition affecting females.
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