Nokea
What associated manifestation might the nurse occasionally find in a child diagnosed with Wilms tumor?
- A. Atrial fibrillation
- B. Hypertension
- C. Endocarditis
- D. Hyperlipidemia
Correct Answer: B
Rationale: Wilms tumor, due to its location in the kidney, can be associated with secondary hypertension.
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On examination, a nurse hears a murmur at the left sternal border (LSB) in a child with diarrhea and fever. The parent asks why the pediatrician never mentioned the murmur. The nurse explains:
- A. The pediatrician is not a cardiologist.
- B. Murmurs are difficult to detect, especially in children.
- C. The fever increased the intensity of the murmur.
- D. We need to refer the child to an interventional cardiologist.
Correct Answer: C
Rationale: The increased cardiac output associated with fever can accentuate a heart murmur, making it more noticeable.
An infant with congestive heart failure is receiving digoxin (Lanoxin). What does the nurse recognize as a sign of digoxin toxicity?
- A. Restlessness
- B. Decreased respiratory rate
- C. Increased urinary output
- D. Vomiting
Correct Answer: D
Rationale: Symptoms of digoxin toxicity include nausea, vomiting, anorexia, irregularity in pulse rate and rhythm, and a sudden change in pulse.
Blunt or shallow Y descent in jugular venous waveform is seen in all, except
- A. Tricuspid stenosis
- B. Cardiac tamponade
- C. Effusive-constrictive pericarditis
- D. Ebstein's anomaly
Correct Answer: D
Rationale: Ebstein's anomaly is not typically associated with a blunt or shallow Y descent in the jugular venous waveform.
In childhood, hypokalaemic alkalosis is a recognised finding:
- A. In a baby given feeds that are too concentrated
- B. In congenital pyloric stenosis
- C. In cystic fibrosis
- D. Following urinary diversion
Correct Answer: B
Rationale: Hypokalaemic alkalosis is a hallmark of congenital pyloric stenosis due to vomiting. It is not typically associated with concentrated feeds, cystic fibrosis, or urinary diversion.
Closure of ductus will worsen following conditions
- A. Coarctation of Aorta
- B. TGA without VSD
- C. Pulmonary Atresia
- D. Hypoplastic left heart
Correct Answer: C
Rationale: Closure of the ductus arteriosus worsens pulmonary atresia by cutting off pulmonary blood flow.