What is the definition of a giant coronary artery aneurysm in Kawasaki Disease?
- A. ≥8 mm in diameter
- B. Z score ≥10
- C. Both A and B
- D. None of the above
Correct Answer: C
Rationale: A giant coronary artery aneurysm in Kawasaki Disease is defined by either a diameter of ≥8 mm or a Z score ≥10, which indicates a significantly increased size.
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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.
Regarding hand innervation:
- A. Median nerve supplies all thenar muscles except adductor pollicis
- B. The sensory supply to the dorsal surface of the medial two digits is via the radial nerve
- C. In ulnar nerve damage at the elbow there is sensory loss over the medial aspect of forearm proximal to the wrist
- D. Radial nerve provides the sensory innervation to the terminal areas of the dorsal surfaces of the lateral three digits
Correct Answer: A
Rationale: The median nerve innervates most thenar muscles, except for the adductor pollicis, which is supplied by the ulnar nerve.
Management of thalassaemia includes:
- A. Whole blood transfusions
- B. Pneumovax
- C. Bone marrow transplant
- D. Penicillin V prophylaxis
Correct Answer: C
Rationale: The correct answer is C because bone marrow transplant is a curative treatment for thalassaemia. The other options (a, b, d, e) are supportive treatments but not curative.
Neural crest derivatives include:
- A. Adrenal cortical cells
- B. Melanocytes
- C. Langerhans cells
- D. Gastric epithelial cells
Correct Answer: B
Rationale: Melanocytes are derived from the neural crest and are responsible for pigment production in the skin.
What does the surgical closure of the ductus arteriosus do?
- A. Stop the loss of unoxygenated blood to the systemic circulation
- B. Decrease the edema in legs and feet
- C. Increase the oxygenation of blood
- D. Prevent the return of oxygenated blood to the lungs
Correct Answer: D
Rationale: The ductus arteriosus allows blood to flow from the higher-pressure aorta to the lower-pressure pulmonary artery, causing a right-to-left shunt. If this is surgically closed, no additional oxygenated blood (from the aorta) will return to the lungs through the pulmonary artery. The aorta carries oxygenated blood to the systemic circulation. Because of the higher pressure in the aorta, blood is shunted into the pulmonary artery and the pulmonary circulation. Edema in the legs and feet is usually a sign of heart failure. This repair would not directly affect the edema. Increasing the oxygenation of blood would not interfere with the return of oxygenated blood to the lungs.