What does the nurse need to assess first when caring for a child with a suspected myocardial infarction?
- A. Blood pressure and heart rate
- B. Chest pain and anxiety levels
- C. Oxygen saturation and respiratory rate
- D. Electrocardiogram and heart sounds
Correct Answer: D
Rationale: The first priority in a suspected myocardial infarction is to assess the heart's electrical activity using an electrocardiogram and listen to heart sounds for any abnormality such as murmurs.
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Galactosaemia:
- A. Exhibits autosomal recessive inheritance
- B. Is associated with cataracts
- C. Results in a low glucose level
- D. Is due to an inability to convert galactose into glucose
Correct Answer: A
Rationale: Galactosaemia is an autosomal recessive disorder. It is associated with cataracts and results from the inability to convert galactose into glucose.
Characteristic indices in anaemia of chronic inflammation:
- A. Increased MCV
- B. Decreased ferritin
- C. Decreased transferrin
- D. Normal MCHC
Correct Answer: C
Rationale: Decreased transferrin: In anaemia of chronic inflammation, transferrin levels decrease due to inflammatory cytokines, which affect iron metabolism and its availability for erythropoiesis.
The nurse is caring for a child who has undergone a cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurse's first action is to:
- A. Call the interventional cardiologist
- B. Notify the cardiac catheterization laboratory that the child will be returning
- C. Apply a bulky pressure dressing over the present dressing
- D. Apply direct pressure 1 inch above the puncture site
Correct Answer: D
Rationale: Direct pressure above the puncture site helps control bleeding by localizing pressure over the vessel.
An infant with trisomy 21 has a complete AV canal defect. Which finding associated with both conditions will the primary care pediatric nurse practitioner expect?
- A. Crackles in both lungs
- B. Hepatomegaly
- C. Oxygen desaturation
- D. Peripheral edema
Correct Answer: C
Rationale: Because infants with trisomy 21 maintain neonatal high pulmonary vascular resistance, they often do not show signs of CHF but instead will have signs of pulmonary hypertension with loud single S2 and desaturation with agitation or effort.
Causes of a dilated renal pelvis in a foetal scan include:
- A. Normal variant
- B. Vesico-ureteric reflux
- C. Pelvi-ureteric junction obstruction
- D. Multicystic kidney
Correct Answer: A
Rationale: A dilated renal pelvis can be a normal variant in a foetal scan, often resolving spontaneously without intervention.