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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What is the priority nursing action for a child who is post-operative following a tonsillectomy?
- A. Provide pain management.
- B. Encourage fluid intake.
- C. Monitor for signs of bleeding.
- D. Educate the child about proper oral hygiene.
Correct Answer: C
Rationale: The priority after a tonsillectomy is to monitor for bleeding, as this can be a serious complication.
In utero heart failure, often with fetal pleural and pericardial effusions and generalized ascites (nonimmune hydrops fetalis) may occur in
- A. ventricular septal defect
- B. coarctation of aorta
- C. d-Transposition of great arteries
- D. single ventricle
Correct Answer: D
Rationale: Single ventricle anatomy can lead to in utero heart failure and hydrops fetalis.
Increased pulmonary markings (increased pulmonary blood flow) is seen in
- A. pulmonary atresia
- B. truncus arteriosus
- C. tetralogy of Fallot
- D. tricuspid atresia
Correct Answer: B
Rationale: Truncus arteriosus results in increased pulmonary blood flow leading to increased pulmonary markings on chest X-ray.
The following are features of encephalitis:
- A. Herpes simplex encephalitis has a reasonably good prognosis
- B. Varicella zoster virus encephalitis is predominantly 'cerebellar'
- C. Mumps encephalitis can cause unilateral nerve deafness
- D. Herpes simplex encephalitis predominantly affects the temporal lobe
Correct Answer: D
Rationale: Herpes simplex encephalitis primarily affects the temporal lobe. Prognosis is poor, and varicella zoster encephalitis is not predominantly cerebellar. Mumps encephalitis can cause deafness.
Mycoplasma pneumonia:
- A. Is associated with bullous myringitis
- B. Cold haemaglutinin antibodies are a recognised finding
- C. Guillain-Barre syndrome is a recognised sequel
- D. Is associated with erythema marginatum
Correct Answer: B
Rationale: Cold haemagglutinin antibodies are a recognized finding in Mycoplasma pneumonia. Bullous myringitis and Guillain-Barre syndrome are also associated.
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