In childhood, hypokalaemic alkalosis is a recognised finding:

Correct Answer: B

Rationale: In childhood, hypokalemic alkalosis is a recognized finding in congenital pyloric stenosis (Option B). This condition is characterized by the narrowing of the pylorus, the opening from the stomach into the small intestine, leading to obstruction of gastric emptying. Vomiting occurs, causing loss of hydrochloric acid and chloride ions, resulting in alkalosis. Option A, feeds that are too concentrated, would not typically lead to hypokalemic alkalosis in childhood. Although concentrated feeds can cause issues, they are more likely to result in other gastrointestinal problems rather than electrolyte imbalances. Option C, cystic fibrosis, is associated with the loss of salt in sweat, leading to a risk of dehydration and electrolyte imbalances. However, it is not a common cause of hypokalemic alkalosis in childhood. Option D, following urinary diversion, is more likely to cause metabolic acidosis rather than alkalosis due to changes in renal function and electrolyte balance post-surgery. In an educational context, understanding the specific etiologies of electrolyte imbalances in pediatric patients is crucial for nurses caring for children with cardiovascular disorders. Recognizing the signs and symptoms of hypokalemic alkalosis, along with its associated conditions like congenital pyloric stenosis, enables prompt identification and appropriate management to prevent complications. This knowledge enhances the quality of care provided to pediatric patients with cardiovascular disorders.

Correct Answer: D

Rationale: In pediatric nursing, understanding encephalitis is crucial for providing effective care. The correct answer is D) Herpes simplex encephalitis predominantly affects the temporal lobe. This is because herpes simplex encephalitis commonly presents with temporal lobe involvement, leading to symptoms like altered mental status and focal neurologic deficits. Option A) is incorrect because herpes simplex encephalitis actually has a poor prognosis if not promptly treated with antiviral medications. Option B) is incorrect as Varicella zoster virus encephalitis typically affects the frontal and temporal lobes, not predominantly cerebellar. Option C) is incorrect as mumps encephalitis is associated with complications like aseptic meningitis but not typically unilateral nerve deafness. Educationally, understanding the specific manifestations of different types of encephalitis is vital for nurses caring for pediatric patients. Recognizing the unique features of each type can aid in early identification, appropriate treatment, and better outcomes for pediatric patients with cardiovascular disorders.

Correct Answer: A

Rationale: Azathioprine is a prodrug, which means it is converted in the body into its active form, 6-mercaptopurine. This active metabolite exerts its immunosuppressive effects by interfering with DNA synthesis, making it an important drug in the management of various autoimmune conditions, including pediatric cardiovascular disorders like Kawasaki disease. Option B, stating that azathioprine is teratogenic, is incorrect. While azathioprine is classified as Pregnancy Category D due to potential risks, teratogenicity is not a primary concern. It should be used cautiously in pregnancy, but its benefits may outweigh the risks in certain situations. Option C, suggesting that azathioprine should be avoided in liver disease, is also incorrect. Azathioprine is primarily metabolized by the liver, so dose adjustments may be necessary in patients with liver dysfunction, but it is not an absolute contraindication. Option D, indicating that the dose of azathioprine should be increased when given with allopurinol, is incorrect. Allopurinol can inhibit the metabolism of azathioprine, leading to increased levels of the active metabolite and potential toxicity. Therefore, the dose of azathioprine should be decreased when used concomitantly with allopurinol. In an educational context, understanding the pharmacology of azathioprine is crucial for pediatric nurses caring for children with cardiovascular disorders requiring immunosuppressive therapy. Knowing that azathioprine is a prodrug helps nurses understand its mechanism of action and potential adverse effects, guiding safe and effective medication administration.

Correct Answer: B

Rationale: In pediatric nursing, understanding pharmacological principles is crucial for safe and effective patient care. In the context of cardiovascular disorders, it is important to be aware of potential side effects of medications. The correct answer is B) Salbutamol. Salbutamol is a beta2-adrenergic agonist commonly used to treat bronchoconstriction in conditions like asthma. It works by relaxing the smooth muscles in the airways, which helps to alleviate bronchoconstriction and improve breathing. A) Captopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension and heart failure. While it can cause side effects like cough and angioedema, bronchoconstriction is not a recognized side effect. C) Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain and inflammation. Bronchoconstriction is not a common side effect of ibuprofen. D) Paracetamol (acetaminophen) is a medication used for pain and fever. It is not known to cause bronchoconstriction. Educationally, understanding the specific side effects of medications is vital for pediatric nurses to provide safe care to their patients. Recognizing potential adverse reactions allows for prompt intervention and prevention of complications, ensuring the well-being of pediatric patients with cardiovascular disorders.

Correct Answer: D

Rationale: In the context of pediatric nursing and cardiovascular disorders, understanding the causes of methaemoglobinaemia is crucial for safe and effective patient care. Methaemoglobinaemia is a condition where the iron in hemoglobin is oxidized, leading to decreased oxygen-carrying capacity. In this case, the correct answer is D) Nitrates. Nitrates are known to induce methaemoglobinaemia, especially in infants who are more susceptible due to lower levels of the enzyme needed to metabolize nitrates. Option A) Paraquat is a herbicide that can cause severe toxicity but is not typically associated with methaemoglobinaemia. Option B) Methylene blue is actually used as an antidote for methaemoglobinaemia due to its ability to convert methemoglobin back to hemoglobin. Option C) Potassium permanganate is a strong oxidizing agent but is not a common cause of methaemoglobinaemia. Educationally, this question highlights the importance of medication safety and the need for nurses to be aware of potential adverse effects of commonly used substances, especially in the pediatric population. Understanding the mechanisms of methaemoglobinaemia and its causes is essential for early recognition and appropriate intervention to ensure optimal patient outcomes.