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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What are FIVE indications for pacemaker insertion in a child with congenital heart block?
- A. Symptomatic bradycardia
- B. Ventricular dysfunction or low cardiac output
- C. Wide QRS escape
- D. Complex ventricular ectopy
Correct Answer: A
Rationale: Symptomatic bradycardia is the most common indication for pacemaker insertion in children with congenital heart block, to ensure adequate heart rate and perfusion.
Nurse Oliver s teaching a mother who plans to discontinue breast-feeding after 5 months. The nurse should advise her to include which foods in her infant’s diet?
- A. Iron-rich formula and baby food
- B. Whole milk and baby food
- C. Skim milk and baby food
- D. Iron-rich formula only
Correct Answer: A
Rationale: Iron-rich formula and baby food provide essential nutrients for a 5-month-old infant transitioning from breastfeeding.
Possible causes of upper airway obstruction are:
- A. Inhaled foreign body in the main bronchus on the right side
- B. Epiglottitis
- C. Retropharyngeal abscess
- D. Viral croup
Correct Answer: B
Rationale: Epiglottitis is a serious condition that can cause acute upper airway obstruction due to swelling of the epiglottis.
Defects of complement system should be suspected in:
- A. Recurrent folliculitis
- B. Facial swelling following trauma
- C. Recurrent meningococcal infection
- D. Pneumocystis carinii pneumonia
Correct Answer: C
Rationale: Recurrent meningococcal infection: Defects in the complement system, especially the terminal complement components, increase the risk of recurrent meningococcal infections.
Regarding cranial nerves:
- A. Meningioma of the olfactory groove may cause unilateral anosmia
- B. Lesion in the geniculate ganglion produces hyperacusis
- C. Frontalis muscle is spared in lower motor neuron facial palsy
- D. In oculomotor palsy, pupillary sparing occurs in early stages of external compression of the nerve by a tumour
Correct Answer: A
Rationale: Meningioma affecting the olfactory groove can compress the olfactory nerve, leading to unilateral anosmia.