In D-transposition of the great vessels, accounts for =5% of all congenital heart disease. In this anomaly, the following are true EXCEPT

Correct Answer: A

Rationale: In D-transposition of the great vessels, the correct answer is A) the pulmonary artery is anterior and to the left of the aorta. This statement is incorrect in this anomaly. In D-transposition, the aorta is anterior and to the right of the pulmonary artery. This anatomical abnormality results in two separate circulatory systems where oxygenated blood circulates in the systemic circulation and deoxygenated blood circulates in the pulmonary circulation, leading to severe hypoxemia if not corrected. Option B) pulmonary veins return to the left atrium is incorrect as in this condition, the pulmonary veins return oxygenated blood to the left atrium. Option C) connections between the atria and ventricles are normal is incorrect as there is usually associated atrial and ventricular septal defects present in D-transposition of the great vessels. Option D) aorta is posterior and to the right of the pulmonary artery is also incorrect as mentioned earlier, the aorta is posterior and to the right of the pulmonary artery in this anomaly. Understanding the anatomical abnormalities in congenital heart diseases like D-transposition of the great vessels is crucial for nurses caring for pediatric patients with these conditions. Recognizing these anomalies aids in providing appropriate care, anticipating complications, and educating patients and families about the condition and treatment options.

Correct Answer: B

Rationale: In pediatric nursing, understanding the side effects of medications like propranolol is crucial for safe and effective care. Propranolol, a beta-blocker commonly used in pediatric patients for cardiovascular conditions, can lead to elevated triglyceride levels as a side effect. This occurs due to its impact on lipid metabolism. Option A, hypothyroidism, is not a common side effect of propranolol use in children. While propranolol can affect thyroid function tests, it typically does not result in clinical hypothyroidism. Option C, school performance problems, is not a direct side effect of propranolol. While certain side effects like fatigue or dizziness may impact school performance indirectly, it is not a primary side effect of this medication. Option D, pulmonary fibrosis, is not associated with propranolol use. Pulmonary fibrosis is a rare side effect of some other medications like certain chemotherapeutic agents or antiarrhythmic drugs, but not beta-blockers like propranolol. Educationally, this question highlights the importance of understanding medication side effects in pediatric patients. It reinforces the need for nurses to be vigilant in monitoring for potential adverse effects and taking appropriate actions to ensure the safety and well-being of their young patients.

Correct Answer: A

Rationale: In pediatric nursing, understanding the complications of infective endocarditis is crucial for providing effective care. In this scenario, the correct answer is A) heart failure. This is the most common morbidity because infective endocarditis can lead to significant damage to the heart valves, resulting in impaired cardiac function and ultimately heart failure. Option B) pulmonary emboli is less common in pediatric infective endocarditis compared to adults. Pulmonary emboli occur when blood clots travel to the lungs, which is not a primary complication seen in pediatric cases. Option C) mycotic aneurysms can occur in infective endocarditis, but they are not as common as heart failure in terms of morbidity. Mycotic aneurysms are localized dilations of blood vessels due to infection, which can lead to serious complications but are not as prevalent as heart failure. Option D) acquired ventricular septal defect is a possible complication of infective endocarditis, but it is not as common as heart failure. Ventricular septal defects are abnormal communications between the two lower chambers of the heart and can result from the infection damaging the heart structures. Educationally, understanding the most common morbidities associated with infective endocarditis in pediatric patients is essential for nurses to provide optimal care and monitoring. Recognizing signs of heart failure early, such as respiratory distress, poor feeding, and tachycardia, can lead to timely interventions and improved outcomes for these vulnerable patients.

Correct Answer: B

Rationale: In pediatric nursing, understanding cardiovascular disorders, including cardiac tumors, is crucial for providing effective care. The correct answer, option B) rhabdomyomas, is the most common pediatric cardiac tumor. Rhabdomyomas are typically benign and often found in the heart, especially in infants. They are associated with tuberous sclerosis, a genetic disorder. Option A) fibromas are less common in pediatric cardiac tumors compared to rhabdomyomas. Fibromas are more frequently seen in older children and can cause structural issues in the heart. Option C) myxomas are more commonly seen in adults than in pediatric patients. They are primary cardiac tumors that arise from the endocardium. Option D) hemangiomas are vascular tumors but are not typically found in the heart. They are more commonly seen in the skin and liver in pediatric patients. Understanding the prevalence, characteristics, and associations of different cardiac tumors in pediatric patients is essential for nurses caring for children with cardiovascular disorders. Recognizing the most common types of tumors helps in early detection, appropriate management, and improving patient outcomes.

Correct Answer: D

Rationale: In pediatric nursing, understanding the importance of measuring serum potassium levels in children with confirmed hypertension is crucial for detecting potential underlying conditions. In this scenario, the correct answer is D) apparent mineralocorticoid excess (AME). AME is a rare genetic disorder characterized by hypertension, low renin and aldosterone levels, and hyperkalemia. Due to the impaired activity of the enzyme 11-beta hydroxysteroid dehydrogenase type 2, which normally inactivates cortisol to cortisone in the kidney, cortisol can bind to mineralocorticoid receptors, leading to increased sodium reabsorption and potassium excretion. Option A) Liddle syndrome and B) Gordon syndrome are both characterized by hypertension but typically present with hypokalemia rather than hyperkalemia. In Liddle syndrome, there is increased renal sodium reabsorption through epithelial sodium channels, while Gordon syndrome involves mutations in WNK kinases affecting sodium-chloride cotransporters. Option C) glucocorticoid remediable aldosteronism (GRA) is associated with hypertension and low renin levels, but hyperkalemia is not a typical feature. In GRA, aldosterone is produced under the control of adrenocorticotropic hormone (ACTH) due to a chimeric gene. Educationally, recognizing these distinct genetic disorders affecting potassium levels and blood pressure regulation in pediatric patients is vital for accurate diagnosis and management. Monitoring serum potassium levels helps identify specific conditions like AME, guiding appropriate treatment strategies and improving patient outcomes.