The assessment that would lead the nurse to suspect that a newborn infant has a ventricular septal defect is:

Correct Answer: A

Rationale: A loud, harsh murmur with systolic tremor (A) is classic for ventricular septal defect due to blood shunting. Cyanosis (B) is variable, BP difference (C) is coarctation, and machinery murmur (D) is PDA. Document: 'A loud, harsh murmur combined with a systolic thrill is characteristic.'

Correct Answer: D

Rationale: For a 1-year-old (10 kg) with anaphylaxis (urticaria, wheeze post-peanut ingestion), the correct adrenaline dose is 0.15 mL of 1:1000 IM (0.15 mg), per guidelines (0.01 mg/kg). Choice A (0.1 mL 1:1000) is 0.1 mg, underdosing. Choice B (0.1 mL 1:10,000) is 0.01 mg, far too low. Choice C (1 mL 1:10,000) is 0.1 mg, still inadequate. Choice D (0.1 mL 1:10,000 SC) is incorrect dose and route (IM preferred). None match the standard, but typically 0.15 mL 1:1000 IM is correct.

Correct Answer: D

Rationale: Ecthyma gangrenosum is the classic Pseudomonas lesion, featuring necrotic ulcers, especially in immunocompromised patients (IDSA). Erythema multiforme is immune-related, nodules are nonspecific, pustular melanosis is neonatal, and cellulitis lacks specificity.

Correct Answer: B

Rationale: Standard is 0.5-1 g/kg/day of intralipid, not mg/kg (ASPEN). Assuming a typo, 0.5 g/kg aligns with A’s intent as the minimal dose to prevent deficiency.

Correct Answer: D

Rationale: Counseling addresses the mother’s distress, improving cooperation while prioritizing care (AAP). Options A-D avoid or worsen the situation.