Nokea
Four-hour old term baby with no prenatal care has features of Trisomy 21. ECG shows left axis deviation
What are the FOUR mechanisms for LV outflow tract obstruction in AVSD?
- A. Gooseneck
- B. Subaortic fibromuscular ridge
- C. Septal hypertrophy
- D. Abnormal LAVV chordal attachments
Correct Answer: B
Rationale: The subaortic fibromuscular ridge is a common cause of LV outflow tract obstruction in AVSD, affecting the smooth flow of blood.
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A nursing action that promotes ideal nutrition in an infant with congestive heart failure (CHF) is:
- A. Feeding formula that is supplemented with additional calories.
- B. Allowing the infant to nurse at each breast for 20 minutes.
- C. Providing large feedings every 5 hours.
- D. Using firm nipples with small openings to slow feedings.
Correct Answer: A
Rationale: Supplementing formula with extra calories increases the caloric density to support growth in infants with CHF.
A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurse’s best response?
- A. Squatting increases the return of venous blood back to the heart.
- B. Squatting decreases arterial blood flow away from the heart.
- C. Squatting is a common resting position when a child is tachycardic.
- D. Squatting increases the workload of the heart.
Correct Answer: A
Rationale: The squatting position allows the child to breathe more easily because systemic venous return is increased.
The nurse is caring for a child with Kawasaki disease. A student nurse who is on the unit asks if there are medications to treat the disease. The nurse’s best response to the student nurse is:
- A. Immunogloulin G and ACE inhibitors
- B. Immunoglobulin and heparin
- C. Immunoglobulin G and aspirin
- D. Immunoglobulin and ibuprofen
Correct Answer: C
Rationale: The standard treatment for Kawasaki disease includes Immunoglobulin G and aspirin to reduce inflammation and prevent coronary artery complications.
A 4-year-old child has had fever, malaise, and vomiting and right-sided abdominal pain for 48 hours. The following are likely diagnoses:
- A. Acute pyelonephritis
- B. Shigella dysentery
- C. Ascaris lumbricoides infestation, if the child is living in the tropics
- D. Right sided tumour
Correct Answer: A
Rationale: Acute pyelonephritis is a common cause of fever, vomiting, and abdominal pain in children. Shigella dysentery typically causes diarrhea, and Ascaris infestation is rare in non-tropical regions. A right-sided tumour is unlikely without other signs.
The nurse reports that a client is at risk for a brain attack (stroke) based on which assessment finding?
- A. Nuchal rigidity
- B. Carotid bruit
- C. Jugular vein distention
- D. Palpable cervical lymph node
Correct Answer: B
Rationale: A carotid bruit indicates turbulent blood flow, which is a risk factor for stroke.