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What is one reason why patients with CHD are more likely to have rejection post-transplant than those with cardiomyopathy?
- A. Sensitized recipients with panel reactive antibody (PRA)
- B. Absence of systemic disease
- C. History of good compliance
- D. None of the above
Correct Answer: A
Rationale: Patients with congenital heart disease (CHD) are often sensitized due to prior surgeries and blood transfusions, leading to a higher risk of rejection post-transplant.
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The nurse is preparing to administer a dose of digoxin (Lanoxin) to a child in heart failure (HF). Which is a beneficial effect of administering digoxin (Lanoxin)?
- A. It decreases edema.
- B. It decreases cardiac output.
- C. It increases heart size.
- D. It increases venous pressure.
Correct Answer: A
Rationale: Digoxin has a rapid onset and is useful for increasing cardiac output, decreasing venous pressure, and, as a result, decreasing edema. Cardiac output is increased by digoxin. Heart size and venous pressure are decreased by digoxin.
All are true about TAPSE (Tricuspid Annular Plane Systolic Excursion), except
- A. Normal TAPSE is >17 mm
- B. Reliable measure of RV systolic function
- C. Can be measured using either M-mode or 2D echo
- D. TAPSE is measured at septal aspect of tricuspid annulus
Correct Answer: D
Rationale: TAPSE is measured at the lateral aspect of the tricuspid annulus, not the septal aspect.
Obstructed total anomalous pulmonary venous return (TAPVR) is a pediatric surgical emergency because
- A. therapy is usually not effective
- B. severe pulmonary congestion
- C. left atrium may be small
- D. left ventricle may be small
Correct Answer: B
Rationale: Obstructed TAPVR requires immediate surgical intervention due to severe pulmonary congestion.
Afterload reducers are not indicated in children with heart failure secondary to
- A. cardiomyopathy
- B. severe mitral insufficiency
- C. aortic stenosis
- D. ventricular septal defect
Correct Answer: C
Rationale: Afterload reducers are contraindicated in conditions where forward flow is already compromised, such as aortic stenosis.
The following tests are routine in the management of an epileptic on carbamazepine:
- A. Blood counts
- B. Serum levels
- C. Liver function tests
- D. Renal function tests
Correct Answer: C
Rationale: Liver function tests are routinely monitored in patients taking carbamazepine due to the risk of liver toxicity, which can occur with prolonged use.