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Which congenital heart defect causes a "boot-shaped" heart on a chest x-ray?
- A. Tetralogy of Fallot
- B. Coarctation of the aorta
- C. Transposition of the great arteries
- D. Ventricular septal defect
Correct Answer: A
Rationale: The correct answer is A: Tetralogy of Fallot. Tetralogy of Fallot, a congenital heart defect with four distinct abnormalities, often presents with a "boot-shaped" heart on chest x-ray due to right ventricular hypertrophy. This characteristic finding is due to the specific combination of defects in this condition. Coarctation of the aorta (choice B), Transposition of the great arteries (choice C), and Ventricular septal defect (choice D) do not typically result in a "boot-shaped" heart on a chest x-ray like Tetralogy of Fallot does.
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An infant with short bowel syndrome will be on total parenteral nutrition (TPN) for an extended period of time. What should the nurse monitor the infant for?
- A. Central venous catheter infection, electrolyte losses, and hyperglycemia
- B. Hypoglycemia, catheter migration, and weight gain
- C. Venous thrombosis, hyperlipidemia, and constipation
- D. Catheter damage, red currant jelly stools, and hypoglycemia
Correct Answer: A
Rationale: Infants with short bowel syndrome requiring prolonged total parenteral nutrition (TPN) are susceptible to central venous catheter infections, electrolyte losses, and hyperglycemia. Monitoring for these complications is crucial to prevent serious outcomes. Choices B, C, and D are incorrect because they do not reflect the common complications associated with prolonged TPN in infants.
Which condition is often associated with a "ground-glass" appearance on a chest x-ray in neonates?
- A. Pneumonia
- B. Respiratory distress syndrome
- C. Bronchopulmonary dysplasia
- D. Congenital diaphragmatic hernia
Correct Answer: B
Rationale: The correct answer is B, Respiratory distress syndrome. Respiratory distress syndrome often presents with a "ground-glass" appearance on a chest x-ray in neonates due to surfactant deficiency. Choice A, Pneumonia, typically appears as patchy infiltrates on chest x-ray. Choice C, Bronchopulmonary dysplasia, is characterized by hyperinflation and fibrosis, not a ground-glass appearance. Choice D, Congenital diaphragmatic hernia, usually shows mediastinal shift and bowel loops in the chest cavity on x-ray, not a ground-glass appearance.
What is an important priority in dealing with the child suspected of having Wilms tumor?
- A. Intervening to minimize bleeding
- B. Monitoring temperature for infection
- C. Ensuring the abdomen is protected from palpation
- D. Teaching parents how to manage parenteral nutrition
Correct Answer: C
Rationale: The correct priority in dealing with a child suspected of having Wilms tumor is ensuring the abdomen is protected from palpation. Palpating the abdomen could lead to tumor dissemination, which is crucial to prevent the spread of cancerous cells. Intervening to minimize bleeding, monitoring temperature for infection, and teaching parents how to manage parenteral nutrition are not the immediate priorities in suspected cases of Wilms tumor.
Which sign is indicative of developmental dysplasia of the hip in infants?
- A. Ortolani sign
- B. Romberg sign
- C. Trendelenburg sign
- D. Gower's sign
Correct Answer: A
Rationale: The Ortolani sign is a specific maneuver used during physical examination to detect hip instability or dislocation in infants. A positive Ortolani sign, where the hip is felt to slip back into the socket, is indicative of developmental dysplasia of the hip, a condition that can lead to long-term disability if not treated early. Romberg sign is used to assess sensory ataxia, Trendelenburg sign indicates weakness of the hip abductor muscles, and Gower's sign is seen in children with proximal muscle weakness climbing up their own body from a supine position due to conditions like muscular dystrophy.
What is the best indicator of fluid balance in a pediatric patient?
- A. Blood pressure
- B. Heart rate
- C. Weight
- D. Urine output
Correct Answer: C
Rationale: Weight is the most accurate indicator of fluid balance in pediatric patients. Changes in weight reflect shifts in body fluid levels more directly compared to other parameters. Blood pressure and heart rate may be affected by various factors other than fluid balance. While urine output is important in assessing renal function, it may not provide a comprehensive picture of overall fluid balance in pediatric patients.