Nokea
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.â€
- B. “He tires out during feedings.â€
- C. “He is fussy for several hours every day.â€
- D. “He sleeps all the time.â€
Correct Answer: B
Rationale: Fatigue during feeding or activity is common to most infants with congenital cardiac problems.
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A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals: HR: 220 beats per minute (regular) Respiratory rate: 30 per minute BP: 84/52 Capillary refill: 3 seconds Which dysrhythmia does the nurse suspect in this child?
- A. Rapid pulmonary flutter
- B. Sinus bradycardia
- C. Rapid atrial fibrillation
- D. Supraventricular tachycardia (SVT)
Correct Answer: D
Rationale: SVT is typically above 200 beats per minute and can result from dehydration; the rapid rate causes low cardiac output (CO), resulting in low BP and prolonged capillary refill.
A 12-month-old child who had repair of a congenital heart defect at 8 months of age has a normal exam and is not taking any medications. The nurse practitioner will contact the child's cardiologist to discuss whether the child needs which medication?
- A. Amoxicillin
- B. Capoten
- C. Digoxin
- D. Furosemide
Correct Answer: A
Rationale: Children who have had complete repair of congenital heart defect (CHD) should have subacute bacterial endocarditis (SBE) prophylaxis with amoxicillin for 6 months after the procedure.
Complications of long-term TPN administration are:
- A. Selenium deficiency
- B. Abnormal liver function tests
- C. Osteopaenia
- D. Renal failure
Correct Answer: A
Rationale: Selenium deficiency is a known complication of long-term total parenteral nutrition (TPN) due to inadequate trace element supplementation.
Toxoplasma gondii infection in humans causes:
- A. Oral ulcers
- B. Cervical lymphadenopathy
- C. Microcephaly
- D. Chorioretinitis
Correct Answer: D
Rationale: Chorioretinitis is a hallmark of congenital toxoplasmosis, leading to vision impairment.
A client who was discharged 8 months ago with cirrhosis and ascites is admitted with anorexia and recent hemoptysis. The client is drowsy but responds to verbal stimuli. The nurse programs a blood pressure monitor to take readings every 15 minutes,. Which assessment should the nurse implement first?
- A. Evaluate distal capillary refill for delayed perfusion
- B. Check the extremities for bruising and petechiae
- C. Examine the pretibial regions for pitting edema
- D. Palpate the abdomen for tenderness and rigidity
Correct Answer: D
Rationale: Palpating the abdomen helps assess for complications such as peritonitis or worsening ascites.