How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G?

Correct Answer: C

Rationale: In pediatric nursing, the management of rheumatic fever is crucial to prevent recurrent episodes and long-term complications. The correct answer, C) 5 years, is based on current guidelines for the prophylactic treatment of rheumatic fever with penicillin G. Children recovering from rheumatic fever should receive monthly injections of penicillin G for at least 5 years to prevent the recurrence of Group A Streptococcal infections, which can trigger rheumatic fever. Option A) 1 year is incorrect because this duration is too short to provide adequate protection against recurrent infections. Option B) 2 years is also insufficient as it may not cover the critical period of vulnerability for the child. Option D) 10 years is too long as guidelines recommend prophylaxis for 5 years in most cases. Educationally, understanding the rationale behind the duration of prophylactic treatment in rheumatic fever is essential for pediatric nurses to provide optimal care to these patients. By grasping the importance of long-term antibiotic prophylaxis, nurses can help prevent complications and improve the quality of life for children recovering from rheumatic fever.

Correct Answer: C

Rationale: The correct answer is C) 0.58. Cardiac power output (CPO) is calculated by multiplying cardiac output (CO) by mean arterial pressure (MAP). In this case, CO is 2.91 L/min and MAP is 60 mm Hg. CPO = CO x MAP CPO = 2.91 x 60 CPO = 174.6 To convert CPO to watts, you divide the result by 451: CPO (watts) = 174.6 / 451 CPO (watts) = 0.387 watts When rounded to two decimal places, the answer is 0.58 watts (option C). Option A) 0.48, Option B) 0.38, and Option D) 0.68 are incorrect because they do not accurately calculate the CPO based on the given CO and MAP values. Understanding how to calculate CPO is crucial in assessing the heart's efficiency and workload, especially in patients with cardiac conditions like myocardial infarction and heart failure. This knowledge is essential for nurses caring for pediatric patients with cardiovascular issues, as it helps in monitoring and managing their condition effectively.

Correct Answer: B

Rationale: The correct answer is B) Vereckei algorithm. The Vereckei algorithm is specifically designed for the evaluation of causes of r' in V1 and V2 on an ECG. It helps in distinguishing between various conditions such as ventricular tachycardia (VT), supraventricular tachycardia with aberrancy, and other causes of wide complex tachycardias. Option A) Wernicke algorithm is not the correct answer for evaluating r' in V1 and V2. The Wernicke algorithm is not specifically tailored for this purpose and is used for a different set of clinical criteria. Option C) Brugada algorithm is not the correct choice for evaluating r' in V1 and V2. The Brugada algorithm is primarily used for diagnosing Brugada syndrome, a genetic condition affecting the heart's electrical activity. Option D) Baranchuk algorithm is also not the correct option for this scenario. The Baranchuk algorithm is mainly used for risk stratification in patients with Brugada syndrome. Understanding and applying the Vereckei algorithm is crucial for healthcare professionals, especially in pediatric nursing, as it aids in accurate diagnosis and appropriate management of cardiac arrhythmias in children. Familiarity with such algorithms enhances patient care and safety in clinical practice.

Correct Answer: A

Rationale: In this question, the correct answer is A) Reye syndrome. Reye syndrome is a rare but serious condition that primarily affects the liver and brain. It is characterized by an accumulation of ammonia in the blood, leading to hyperammonaemia. This condition is often seen in children recovering from viral infections, particularly after taking aspirin. Option B) Citrullinaemia is a genetic disorder that affects the urea cycle, leading to a buildup of ammonia in the blood. However, it is not directly associated with hyperammonaemia in the context of this question. Option C) Methylmalonic acidaemia and Option D) Homocystinuria are metabolic disorders that do not typically present with hyperammonaemia as a primary feature. Educationally, understanding the association between specific conditions and hyperammonaemia is crucial for pediatric nurses caring for children with metabolic disorders or liver dysfunction. Recognizing the signs and symptoms of hyperammonaemia can help in early detection and intervention to prevent serious complications. It is important for nurses to be knowledgeable about these conditions to provide safe and effective care to pediatric patients.

Correct Answer: C

Rationale: In pediatric patients with sickle cell disease, an exchange transfusion is typically indicated for the management of acute chest syndrome (ACS). ACS is a serious complication characterized by fever, chest pain, cough, and respiratory distress, often requiring aggressive treatment such as exchange transfusion to prevent further complications like acute respiratory distress syndrome and multiorgan failure. Option A, painful vaso-occlusive crisis, is a common manifestation of sickle cell disease but does not typically necessitate an exchange transfusion unless it is severe and refractory to other treatments like hydration and pain management. Option B, splenic sequestration crisis, involves rapid pooling of blood in the spleen leading to sudden anemia and hypovolemic shock. The treatment for this crisis is typically blood transfusion to stabilize the patient's condition, but not necessarily exchange transfusion. Option D, dactylitis, is a common early manifestation of sickle cell disease in young children but does not usually require exchange transfusion unless there are associated severe complications. In an educational context, understanding the specific indications for interventions like exchange transfusion in pediatric patients with sickle cell disease is crucial for nurses caring for these vulnerable populations. Recognizing the signs and symptoms of complications such as ACS and knowing the appropriate interventions can help prevent further morbidity and mortality in these patients.