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What are FIVE possible etiologies for a heart rate of 40 bpm with atrial rate of 92 bpm and AV-dissociation in a 4-year-old girl?
- A. Congenital CHB from maternal Lupus
- B. Fetal myocarditis
- C. CCTGA
- D. Medication induced
Correct Answer: A
Rationale: Congenital heart block from maternal conditions like lupus can present with low heart rate and AV dissociation in a young child.
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An 8-year-old female presents with chest pain of 1 day's duration. Five days prior to the pain, she had fever, chills, and myalgias. Physical examination reveals an uncomfortable, anxious, afebrile patient with tachycardia, no murmur, and distant heart sounds. The chest x-ray is shown in Figure 19-2. There is a paradoxical pulse of 22 mm Hg. The most likely diagnosis is
- A. myocarditis
- B. cardiomyopathy
- C. Kawasaki disease
- D. pericarditis
Correct Answer: D
Rationale: Pericarditis causes distant heart sounds, paradoxical pulse, and can follow viral illnesses.
The most common cardiac anomaly associated with Coarctation of aorta is
- A. Bicuspid aortic valve
- B. Subaortic ventricular septal defect
- C. Atrial septal defect
- D. Supramitral ring
Correct Answer: A
Rationale: Bicuspid aortic valve is the most common cardiac anomaly associated with coarctation of the aorta.
While preparing to discharge an 8-month-old infant who is recovering from gastroenteritis and dehydration, the nurse teaches the parents about their infant’s dietary and fluid requirements. The nurse should include which other topic in the teaching session?
- A. Nursery schools
- B. Toilet Training
- C. Safety guidelines
- D. Preparation for surgery
Correct Answer: C
Rationale: Safety guidelines are crucial for an 8-month-old infant who is becoming more mobile and curious, reducing the risk of accidents.
A client with type 2 diabetes mellitus (DM) is admitted to the hospital for uncontrolled DM. Insulin therapy is initiated with an initial dose of Humulin N insulin at 0800. At 1600, the client complains of diaphoresis, rapid heartbeat, and feeling shaky. What should the nurse do first?
- A. Determine the client's current glucose level
- B. Administer 10 units of fast-acting insulin.
- C. Offer the client a snack with high protein.
- D. Increase the IV infusion rate of normal saline.
Correct Answer: A
Rationale: The symptoms suggest hypoglycemia. Checking the glucose level confirms the diagnosis and guides appropriate treatment.
Which of the following is false regarding right ventricle?
- A. It has fine and regular trabeculations
- B. Septal attachment of AV valve is more apical
- C. Moderator band is present
- D. Trabecular septomarginalis is present
Correct Answer: A
Rationale: The right ventricle typically has coarse trabeculations, not fine and regular ones.