Nokea
While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?
- A. Decreased platelet count
- B. Decreased ferritin level
- C. Respiratory alkalosis
- D. Polycythemia
Correct Answer: D
Rationale: Polycythemia is often seen in infants with congenital heart defects that cause decreased pulmonary blood flow, as the body produces more red blood cells to compensate for low oxygen levels.
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Sinus bradycardia in neonates is considered if sinus rate is
- A. <100 beats/min
- B. <90 beats/min
- C. <80 beats/min
- D. <70 beats/min
Correct Answer: A
Rationale: Sinus bradycardia in neonates is typically defined as a heart rate <100 beats/min.
In neonates with anomalous total pulmonary venous return and obstruction, the chest x-ray demonstrates
- A. heart enlarged
- B. prominent pulmonary artery
- C. prominent right ventricle
- D. prominent subaortic stenosis
Correct Answer: D
Rationale: Prominent subaortic stenosis is not typically seen in TAPVR.
Features predisposing to NEC (necrotising enterocolitis) in the neonatal period include:
- A. Short fixation
- B. Asphyxia
- C. Umbilical artery catheter
- D. Maternal Crohn's disease
Correct Answer: B
Rationale: Asphyxia is a known risk factor for necrotizing enterocolitis (NEC) due to its effect on intestinal blood flow, leading to bowel ischemia and increased risk of bacterial translocation.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely “asleep†during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: D
Rationale: The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.
The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin (Lanoxin). Which statement by the parent indicates a need for further instruction?
- A. “If my child vomits after the medication administration, I will repeat the dose.â€
- B. “I will not mix the medication with food.â€
- C. “I will take my child’s pulse before administering the medication.â€
- D. “If more than one dose is missed, I will call the provider.â€
Correct Answer: A
Rationale: Repeating the dose after vomiting can lead to digoxin toxicity, which is dangerous. The parent should be instructed to contact the healthcare provider if vomiting occurs after administration.