Nokea
Which comment made by a parent of a 1-month-old 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 feeding or activity is common to most infants with congenital cardiac problems.
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Which among the following is not an admixture lesion?
- A. Transposition of great arteries
- B. Truncus arteriosus
- C. Total anomalous pulmonary venous connection
- D. Pulmonary atresia with intact ventricular septum
Correct Answer: D
Rationale: Pulmonary atresia with intact ventricular septum is not an admixture lesion.
Patients with a small PDA have the following criteria EXCEPT
- A. asymptomatic risk for endocarditis
- B. normal peripheral pulses
- C. normal pulmonary artery pressure
- D. normal life expectancy
Correct Answer: A
Rationale: Small PDAs typically have a low risk for endocarditis.
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.
Gingival hyperplasia is an adverse effect of therapy with:
- A. Phenytoin
- B. Cyclophosphamide
- C. Frusemide
- D. Carbamazepine
Correct Answer: A
Rationale: Phenytoin, an anticonvulsant medication, is well-known for causing gingival hyperplasia as a side effect.
Regarding diphtheria correct statement is
- A. Falling levels of immunity in the adult population is a reason for sporadic cases in the immunization era
- B. Immunization abolishes carrier state
- C. Antibiotic prophylaxis is not indicated for asymptomatic case contacts who are not carriers (negative cultures)
- D. Asymptomatic case contacts who are carriers should be administered antibiotic prophylaxis and antitoxin
Correct Answer: A
Rationale: Falling immunity levels in adults contribute to sporadic cases of diphtheria even in the immunization era.