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Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect?
- A. A loud, harsh murmur with a systolic thrill
- B. Cyanosis when crying
- C. Blood pressure higher in the arms than in the legs
- D. A machinery-like murmur
Correct Answer: A
Rationale: A loud, harsh murmur with a systolic thrill is a hallmark sign of a ventricular septal defect in newborns.
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Which comment made by a parent of a 1-month-old infant would alert the nurse about the presence of a congenital heart defect?
- A. He is always hungry.'
- B. He tires out during feedings.'
- C. He is fussy for several hours every day.'
- D. He sleeps all the time.'
Correct Answer: B
Rationale: Fatigue during feedings is a common sign of congenital heart defects due to increased cardiac workload.
Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood?
- A. The patent ductus arteriosus
- B. A ventricular septal defect
- C. The closure of the foramen ovale
- D. An atrial septal defect
Correct Answer: D
Rationale: An atrial septal defect allows oxygenated blood to shunt from the left to the right side, supporting circulation in hypoplastic left heart syndrome.
The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parent asks the nurse, 'How does Kawasaki disease affect my child's heart and blood vessels?' On what understanding is the nurse's response based?
- A. Inflammation weakens blood vessels, leading to aneurysm.
- B. Increased lipid levels lead to the development of atherosclerosis.
- C. Untreated disease causes mitral valve stenosis.
- D. Altered blood flow increases cardiac workload with resulting heart failure.
Correct Answer: A
Rationale: Kawasaki disease causes vasculitis, weakening vessel walls and increasing the risk of aneurysms.
What are the four structural heart anomalies that make up the tetralogy of Fallot?
- A. Hypertrophied right ventricle
- B. Patent ductus arteriosus
- C. Ventral septal defect
- D. Narrowing of pulmonary artery
- E. Dextroposition of aorta
Correct Answer: A,B,D,E
Rationale: Tetralogy of Fallot includes a hypertrophied right ventricle, patent ductus arteriosus, pulmonary artery stenosis, and dextroposition of the aorta. Note: The document incorrectly lists 'ventral septal defect' instead of 'ventricular septal defect,' but the correct term is assumed.
How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G?
- A. 1 year
- B. 2 years
- C. 5 years
- D. 10 years
Correct Answer: C
Rationale: Monthly penicillin G injections for at least 5 years prevent recurrent rheumatic fever in children.