In severe form of Tetralogy of Fallot, all are true Except:

Correct Answer: A

Rationale: In the severe form of Tetralogy of Fallot, marked cardiomegaly in chest X-ray is not typically seen. The correct answer, A, is true because cardiomegaly is not a common feature of Tetralogy of Fallot. Central cyanosis and clubbing (B) are common due to decreased pulmonary blood flow and chronic hypoxemia. Basal ejection systolic murmur and a single 2nd heart sound (C) are characteristic of Tetralogy of Fallot due to the pulmonary stenosis and right ventricular outflow tract obstruction. Right ventricular hypertrophy on ECG (D) is also expected in Tetralogy of Fallot due to the increased workload on the right ventricle. Educationally, understanding the specific signs and symptoms of Tetralogy of Fallot is crucial for pediatric nurses to provide appropriate care and interventions for children with this congenital heart defect. By knowing the distinct features of the condition, nurses can monitor and manage the child's condition effectively, ensuring optimal outcomes and quality of life. This knowledge also enables early recognition of complications and timely interventions, ultimately improving patient outcomes and well-being.

Correct Answer: C

Rationale: Acute laryngotracheobronchitis, also known as croup, is a common respiratory condition in children characterized by inflammation of the larynx, trachea, and bronchi. The radiological sign associated with acute laryngotracheobronchitis is the "steeple sign," which refers to the characteristic subglottic narrowing and tapered appearance on imaging studies. This sign is indicative of the narrowing of the airway at the level of the cricoid cartilage, a hallmark feature of croup. Option A, generalized hyperinflation, is not typically seen in acute laryngotracheobronchitis. Hyperinflation is more commonly associated with conditions like asthma or chronic obstructive pulmonary disease. Option B, lobar consolidation, is not a typical finding in croup. Lobar consolidation is more commonly seen in conditions such as pneumonia, where there is a buildup of fluid or pus in a specific lobe of the lung. Option D, thumb sign, is associated with epiglottitis, another upper airway condition. The thumb sign refers to swelling of the epiglottis, leading to a thumb-like appearance on imaging studies. This finding is not specific to acute laryngotracheobronchitis. Understanding the radiological signs associated with different respiratory conditions is crucial for pediatric nurses in diagnosing and managing these conditions effectively. Recognizing the steeple sign in acute laryngotracheobronchitis can help healthcare providers initiate appropriate treatment promptly. It is essential for nurses to be able to differentiate between various radiological signs to provide optimal care for pediatric patients with respiratory illnesses.

Correct Answer: C

Rationale: In this scenario, the most likely diagnosis for a preterm infant presenting with sudden respiratory distress, decreased breath sounds, and increased transillumination on one side is C) Pneumothorax. A pneumothorax occurs when air leaks into the space between the lung and chest wall, causing lung collapse and subsequent respiratory distress. Transient tachypnea of the newborn (A) is characterized by rapid breathing due to retained lung fluid, typically resolving within 24-72 hours without decreased breath sounds or transillumination. Meconium aspiration syndrome (B) results from fetal distress causing the infant to pass meconium into the amniotic fluid, leading to airway obstruction and chemical pneumonitis, not pneumothorax. Neonatal pneumonia (D) presents with systemic signs of infection and may have abnormal breath sounds but is less likely to cause unilateral transillumination. Educational context: Understanding these differential diagnoses in pediatric nursing is crucial for timely and accurate intervention. Pneumothorax can be life-threatening in infants and requires immediate attention to prevent respiratory compromise. Nurses must be able to recognize the signs and symptoms of various respiratory conditions in neonates to provide prompt and effective care.

Correct Answer: D

Rationale: In this scenario, the most likely diagnosis for a neonate presenting with cyanosis that worsens with feeding and improves with crying is choanal atresia, making option D the correct answer. Choanal atresia is a congenital condition where there is a blockage of the nasal passage due to bony or membranous tissue, leading to difficulty breathing through the nose. When the neonate cries, they are able to improve oxygenation by breathing through their mouth, alleviating the cyanosis temporarily. Option A, Tetralogy of Fallot, is characterized by a set of four heart defects and typically presents with cyanosis that is not influenced by crying or feeding. Option B, Respiratory distress syndrome, usually presents with respiratory distress, tachypnea, and grunting, rather than the specific cyanosis pattern described in the question. Option C, Transposition of the great arteries, would present with severe cyanosis from birth and would not typically improve with crying. Educationally, understanding the different presentations of cyanosis in neonates is crucial for pediatric nurses to provide timely and appropriate care. Recognizing the specific signs and symptoms associated with various conditions allows for prompt intervention and treatment, ultimately improving patient outcomes. It is essential for nurses to have a solid foundation in pediatric conditions to accurately assess, diagnose, and intervene in neonatal emergencies.

Correct Answer: C

Rationale: The correct answer is C) Transient tachypnea of the newborn. Transient tachypnea of the newborn (TTN) is a common respiratory condition in term infants. The presentation of tachypnea, grunting, nasal flaring, and chest X-ray findings of fluid in lung fissures are classic signs of TTN. TTN occurs due to delayed reabsorption of fetal lung fluid after birth, leading to respiratory distress. Option A) Neonatal pneumonia typically presents with fever, poor feeding, and signs of systemic infection, which are not described in the scenario. Option B) Respiratory distress syndrome (RDS) is more common in preterm infants and is due to surfactant deficiency. Chest X-ray findings in RDS would show a ground-glass appearance rather than fluid in lung fissures. Option D) Meconium aspiration syndrome is characterized by meconium-stained amniotic fluid, respiratory distress, and possible chemical pneumonitis from meconium aspiration. It does not typically present with the chest X-ray findings described in the scenario. Educationally, understanding the differential diagnoses of respiratory distress in newborns is crucial for pediatric nurses. Recognizing the signs and symptoms of TTN, as well as differentiating it from other conditions, allows for prompt and appropriate management to ensure optimal outcomes for the newborn.