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1. Which cardiac defects are associated with tetralogy of Fallot?
- A. Right ventricular hypertrophy, atrial and ventricular defects, and mitral valve stenosis
- B. Origin of the aorta from the right ventricle and of the pulmonary artery from the left ventricle
- C. Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta
- D. Altered connection between the pulmonary artery and the aorta, right ventricular hypertrophy, and an atrial septal defect
Correct answer: C
Rationale: Tetralogy of Fallot is characterized by a combination of four specific cardiac defects: right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of tetralogy of Fallot. Choice B describes transposition of the great arteries rather than tetralogy of Fallot. Choice D includes an atrial septal defect, which is not part of the classic presentation of tetralogy of Fallot.
2. A 2-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the primary goal of therapy during the acute phase?
- A. Preventing coronary artery aneurysms
- B. Reducing fever
- C. Improving cardiac function
- D. Preventing dehydration
Correct answer: A
Rationale: The primary goal of therapy during the acute phase of Kawasaki disease is to prevent coronary artery aneurysms, which are a serious complication of this condition. Coronary artery aneurysms can lead to long-term cardiovascular issues, making prevention crucial. While reducing fever and improving cardiac function are important aspects of managing Kawasaki disease, the primary focus in the acute phase is on preventing coronary artery aneurysms. Dehydration prevention is also essential but not the primary goal during the acute phase of this disease.
3. Which cardiac defects are associated with tetralogy of Fallot?
- A. Right ventricular hypertrophy, atrial and ventricular defects, and mitral valve stenosis
- B. Origin of the aorta from the right ventricle and of the pulmonary artery from the left ventricle
- C. Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta
- D. Altered connection between the pulmonary artery and the aorta, right ventricular hypertrophy, and an atrial septal defect
Correct answer: C
Rationale: The correct answer is C: Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta are the cardiac defects associated with Tetralogy of Fallot. In Tetralogy of Fallot, these specific abnormalities contribute to the classic features of the condition. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of Tetralogy of Fallot. Choice B describes transposition of the great arteries, not Tetralogy of Fallot. Choice D mentions an altered connection between the pulmonary artery and the aorta, which is not a defining characteristic of Tetralogy of Fallot.
4. A child with a fever is prescribed acetaminophen. What should the caregiver teach the parents about administering this medication?
- A. Administer the medication with food
- B. Measure the dose with a household spoon
- C. Measure the dose with a proper measuring device
- D. Administer the medication only when the child has a high fever
Correct answer: C
Rationale: The correct answer is to measure the dose with a proper measuring device. Using a household spoon can lead to inaccurate dosing, which can be dangerous. Administering the medication with food or only when the child has a high fever are not the essential instructions related to the safe and effective administration of acetaminophen.
5. The nurse is admitting a child with a Wilms tumor. Which is the initial assessment finding associated with this tumor?
- A. Abdominal swelling
- B. Weight gain
- C. Hypotension
- D. Increased urinary output
Correct answer: A
Rationale: Abdominal swelling is frequently the initial assessment finding associated with a Wilms tumor. This swelling is caused by the tumor's mass in the kidney, leading to abdominal distension. Weight gain (Choice B) is less likely as a primary finding, as it may occur later due to tumor growth or fluid retention. Hypotension (Choice C) is not typically associated with Wilms tumor unless severe complications like hemorrhage develop. Increased urinary output (Choice D) is not a common initial finding; instead, hematuria or other urinary changes may be observed later in the disease process.
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