False positive tuberculin test may be present in:

Correct Answer: C

Rationale: In the context of a pediatric NCLEX practice quiz, the false positive tuberculin test being present in infection with atypical mycobacteria (Option C) is the correct answer. This is because atypical mycobacteria, such as Mycobacterium avium complex, can cause cross-reactions with the tuberculin test due to similarities in their cell wall antigens to those of Mycobacterium tuberculosis. Option A, disseminated infection, is incorrect because a disseminated infection of tuberculosis would likely result in a true positive tuberculin test rather than a false positive. Option B, live viral vaccine, is incorrect as live viral vaccines, like the MMR vaccine, do not typically cause false positive tuberculin tests. Option D, active infection, is also incorrect because active tuberculosis infection would lead to a true positive tuberculin test result. Understanding why certain conditions or factors can lead to false positive results in diagnostic tests is crucial in clinical practice, especially in the field of pediatrics where accurate diagnosis is essential for providing appropriate care to children. This knowledge helps healthcare professionals interpret test results accurately and make informed decisions regarding further investigations or treatment options.

Correct Answer: C

Rationale: In this question, the correct answer is C) Severe coarctation of the aorta. This congenital heart defect is associated with heart failure in newborns due to the obstruction of blood flow from the left ventricle to the rest of the body. The narrowing of the aorta leads to increased pressure in the left ventricle, causing strain on the heart and ultimately leading to heart failure. Option A) Large VSD (ventricular septal defect) and option B) Large ASD (atrial septal defect) are not typically associated with heart failure in newborns unless there are additional complicating factors present. VSD and ASD are defects that allow blood to flow between the chambers of the heart, but they do not directly cause the same level of obstruction and strain on the heart as coarctation of the aorta. Option D) Severe Tetralogy of Fallot is a cyanotic heart defect that involves a combination of four heart abnormalities. While Tetralogy of Fallot can lead to cyanosis and low oxygen levels, it is not typically associated with heart failure in newborns as the primary issue is oxygenation rather than heart failure. It is important for nurses and healthcare providers to understand the different types of congenital heart defects and their implications for newborns. Recognizing the signs and symptoms of heart failure in newborns with congenital heart disease is crucial for prompt intervention and appropriate management to improve outcomes.

Correct Answer: C

Rationale: In pediatric nursing, understanding the clinical manifestations of acute congestive heart failure is crucial for accurate assessment and intervention. In this case, option C, "Firm non-tender liver," is the correct answer. This is because in acute congestive heart failure, the liver may become enlarged and congested due to venous congestion, leading to hepatomegaly. However, the liver typically remains soft and tender in this condition. Option A, "Edema lower limb," is a common clinical manifestation of congestive heart failure due to fluid retention and increased hydrostatic pressure in the veins, leading to swelling in dependent areas like the lower limbs. Option B, "Congested pulsating neck veins," is also seen in acute congestive heart failure as a result of increased central venous pressure, leading to engorgement and pulsation of the jugular veins. Option D, "Basal lung crepitations," are typically present in congestive heart failure due to fluid accumulation in the lungs, leading to crackling sounds upon auscultation in the basal areas. Educationally, understanding these clinical signs helps nurses differentiate between various conditions presenting similarly and tailor care to address the specific needs of the pediatric patient. Recognizing the subtle differences in these manifestations is essential for early identification, prompt treatment, and improved outcomes in children with acute congestive heart failure.

Correct Answer: C

Rationale: In infants with a large ventricular septal defect (VSD), it is crucial to understand the clinical findings associated with this congenital heart defect. The correct answer, option C, "Normal growth parameter," is the exception among the listed findings. A) Option A, a grade II pansystolic murmur in the left parasternal area, is often present in infants with VSD due to the turbulent blood flow across the defect. B) Option B, an accentuated second heart sound on the second left intercostal space, can be heard in VSD as the defect causes increased blood flow through the pulmonary valve. D) Option D, a hyperdynamic precordium, is commonly observed in infants with VSD due to the increased cardiac output. Understanding these clinical findings is important for nurses and healthcare professionals caring for pediatric patients with congenital heart defects. Recognizing these signs can aid in early identification, appropriate management, and improved outcomes for these infants. Monitoring growth parameters is essential in pediatric care but is not a specific clinical finding associated with VSD.

Correct Answer: A

Rationale: In pediatric patients, the most common cause of pleural effusion is bacterial pneumonia. This is because bacterial pneumonia often leads to an inflammatory response in the lungs, resulting in the accumulation of fluid in the pleural space. This can be due to direct infection of the pleura or secondary to increased capillary permeability. Congestive heart failure can also lead to pleural effusion, but it is less common in children compared to adults. In children, heart failure is usually a result of structural heart defects rather than acquired heart conditions like in adults. Viral pneumonia can cause inflammation in the lungs, but it is less likely to lead to pleural effusion compared to bacterial pneumonia. Viral infections typically result in milder respiratory symptoms in children. Metastatic intrathoracic malignancy can also cause pleural effusion, but it is rare in children. Malignancies are more common in adults and are not typically the first consideration when evaluating a child with pleural effusion. Educationally, understanding the common causes of pleural effusion in children is crucial for pediatric nurses and healthcare providers. Recognizing the etiology can guide appropriate treatment interventions and help improve patient outcomes. It is important to differentiate between different causes of pleural effusion to provide optimal care for pediatric patients presenting with this condition.