Hemophilia A is characterized by:

Correct Answer: C

Rationale: In hemophilia A, which is a genetic disorder caused by a deficiency in clotting factor VIII, the correct answer is C) Prolonged APPT (Activated Partial Thromboplastin Time). This is because hemophilia A specifically affects the intrinsic pathway of the coagulation cascade, leading to a prolonged APPT due to the deficiency of factor VIII. Option A) Prolonged bleeding time is incorrect because bleeding time primarily assesses platelet function, not the clotting factors affected in hemophilia A. Option B) Prolonged prothrombin time is incorrect because prothrombin time evaluates the extrinsic pathway of the coagulation cascade, which is not primarily affected in hemophilia A. Option D) Prolonged thrombin time is incorrect because thrombin time measures the conversion of fibrinogen to fibrin, which is not directly impacted in hemophilia A. Educationally, understanding the specific clotting factors involved in hemophilia A and how they affect different parts of the coagulation pathway is crucial for nurses caring for pediatric patients with this condition. Recognizing the unique laboratory findings in hemophilia A can guide appropriate treatment strategies and interventions to prevent bleeding complications in these patients.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Prostaglandin E1. Infants with marked cyanotic heart defects and decreased pulmonary vascularity often have conditions like ductal-dependent congenital heart diseases (CHD) where a patent ductus arteriosus (PDA) is necessary to maintain systemic blood flow. Prostaglandin E1 helps keep the ductus arteriosus open, allowing for adequate systemic blood flow in these infants. Option A) Epinephrine is used in situations of cardiac arrest or severe hypotension, not specifically for treating cyanotic heart defects. Option C) Dopamine is a medication used to improve cardiac output and blood pressure, but it is not the primary treatment for cyanotic heart defects. Option D) Digoxin is a cardiac glycoside used to treat heart failure and certain arrhythmias, but it is not the appropriate treatment for cyanotic heart defects with decreased pulmonary vascularity. Educationally, understanding the importance of prostaglandin E1 in managing ductal-dependent CHD in infants is crucial for pediatric nursing practice. This knowledge ensures timely and appropriate interventions to support these vulnerable patients, highlighting the significance of accurate medication administration in pediatric cardiac care.

Correct Answer: A

Rationale: In pediatric nursing, understanding heart murmurs is crucial for accurate assessment and diagnosis. Innocent murmurs are common in children and are typically benign, occurring due to normal blood flow patterns rather than underlying cardiac pathology. The timing of a murmur refers to when during the cardiac cycle the murmur occurs. The correct answer is A) Ejection systolic. Innocent murmurs are often ejection systolic in timing, meaning they occur during systole when the blood is being ejected from the heart. This type of murmur is typically heard best at the left sternal border and may have a musical or vibratory quality. Option B) Pansystolic murmurs occur throughout systole and are typically associated with conditions like mitral regurgitation or ventricular septal defects, not innocent murmurs in children. Option C) Early diastolic murmurs occur during early diastole when the heart is filling with blood, seen in conditions like aortic regurgitation, not innocent murmurs. Option D) Mid diastolic murmurs occur in mid-diastole and are associated with conditions like mitral stenosis, not innocent murmurs commonly heard in pediatric patients. Educationally, it is important for nursing students to grasp the different types of heart murmurs, their timing, associated conditions, and significance in pediatric patients. Recognizing innocent murmurs helps differentiate them from pathological murmurs, leading to appropriate patient management and referrals to cardiology for further evaluation when necessary. This knowledge enhances the quality of care provided to pediatric populations and contributes to improved patient outcomes.

Correct Answer: A

Rationale: In this question, the correct answer is A) Large atrial septal defect. An apical mid diastolic rumble is typically associated with mitral stenosis, which occurs due to turbulent blood flow across a stenotic mitral valve during diastole. This rumble is caused by the increased velocity of blood flow and resulting vibrations that can be auscultated at the apex of the heart. Option A is incorrect because an atrial septal defect involves abnormal communication between the atria and does not directly affect the flow of blood across the mitral valve, hence an apical mid diastolic rumble is not typically heard in this condition. Options B, C, and D all involve mitral valve pathology which can lead to the development of an apical mid diastolic rumble due to the turbulent blood flow across the stenotic or incompetent valve. Mitral incompetence and mitral valve stenosis both affect the flow of blood through the mitral valve, leading to the characteristic auscultatory findings associated with these conditions. Aortic rheumatic carditis with mitral valvulitis can also cause turbulent blood flow across the mitral valve leading to the same auscultatory finding. Understanding the characteristic heart sounds associated with different structural heart diseases is crucial in pediatric nursing as it helps in accurate diagnosis and monitoring of these conditions in pediatric patients. Nurses need to be able to differentiate between various heart sounds to provide optimal care and timely interventions for their pediatric patients with cardiac issues.

Correct Answer: D

Rationale: In the context of pediatric nursing and the assessment of rheumatic fever (RF), it is crucial to understand the criteria for determining the activity of the disease. In this question, the correct answer is D) Prolonged PR interval on ECG. This is because a prolonged PR interval on an electrocardiogram (ECG) is a classic finding in RF due to its impact on the conduction system of the heart. Option A) Fever of 38°C or more for 3 successive days is incorrect because fever is a common symptom in active RF, so its presence would actually support the diagnosis of active disease. Option B) Positive acute phase reactant is incorrect because elevated acute phase reactants like ESR and CRP are typically seen in active RF, further supporting the diagnosis. Option C) Sleeping pulse > 100 bpm is incorrect because tachycardia, especially with exertion or at rest, is a common finding in active RF due to the inflammatory response affecting the heart's function. Educationally, understanding the clinical manifestations and diagnostic criteria of RF is essential for pediatric nurses to provide timely and appropriate care for children with this condition. Recognizing the specific cardiac manifestations, such as the prolonged PR interval on ECG, helps in early identification and management of RF to prevent complications like rheumatic heart disease.