Nokea
What does the nurse explain that a ventricular septal defect will allow?
- A. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
- B. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis
- C. No shunting because of high pressure in the left ventricle
- D. Increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume
Correct Answer: A
Rationale: Pulmonary blood flow is increased when a ventricular septal defect exists. The blood shifts from left to right because of the higher pressure in the left ventricle. This particular shift does not cause cyanosis.
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An 8-month-old infant has a hypercyanotic spell while blood is being drawn. What is the priority nursing action?
- A. Assess for neurologic defects
- B. Place the child in the knee-chest position
- C. Begin cardiopulmonary resuscitation
- D. Prepare family for imminent death
Correct Answer: B
Rationale: The first action is to place the infant in the knee-chest position. Blow-by oxygen may be indicated. Neurologic defects are unlikely. The child should be assessed for airway, breathing, and circulation. Often, calming the child and administering oxygen and morphine can alleviate the hypercyanotic spell.
While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?
- A. Decreased platelet count
- B. Polycythemia
- C. Decreased ferritin level
- D. Shift to the left
Correct Answer: B
Rationale: Chronic hypoxemia in CHD leads to polycythemia as a compensatory mechanism.
A 6-month-old presents with tachycardia, tachypnea, and poor feeding for 3 months. Physical examination reveals a continuous machinery murmur and a wide pulse pressure with a prominent apical impulse. The most likely diagnosis is
- A. pulmonic stenosis
- B. aortic stenosis
- C. ventricular septal defect
- D. patent ductus arteriosus
Correct Answer: D
Rationale: Patent ductus arteriosus causes a continuous machinery murmur and wide pulse pressure.
All of the following are part of acute aortic syndrome, except
- A. Aortic dissection
- B. Acute aortic regurgitation
- C. Intramural hematoma
- D. Penetrating atherosclerotic ulcer
Correct Answer: B
Rationale: Acute aortic regurgitation is not typically considered part of acute aortic syndrome.
The following conditions are associated with hyperammonaemia:
- A. Reye syndrome
- B. Citrullinaemia
- C. Methylmalonic acidaemia
- D. Homocystinuria
Correct Answer: A
Rationale: Reye syndrome is associated with hyperammonaemia due to liver dysfunction and impaired urea cycle function, leading to ammonia accumulation.