The following are strongly associated with Kawasaki disease EXCEPT

Correct Answer: B

Rationale: Kawasaki disease is an acute febrile illness that primarily affects children. The correct answer is B) first-degree heart block is not strongly associated with Kawasaki disease. A) Duration of fever of >16 days is associated with Kawasaki disease because prolonged fever is a common symptom of the condition. C) Male gender is a risk factor for Kawasaki disease as it is more commonly seen in boys than girls. D) Age of <1 year is a risk factor for Kawasaki disease, as children under the age of 1 are more susceptible to developing the condition. Educationally, understanding the clinical manifestations and risk factors associated with Kawasaki disease is crucial for pediatric nurses to recognize and provide timely intervention. By knowing the typical presentations and characteristics of the disease, nurses can facilitate early diagnosis and management, ultimately improving patient outcomes.

Correct Answer: D

Rationale: In this question, the correct answer is D) pentostam. Pentostam is not known to cause long Q-T syndrome (LQTS). A) Trimethoprim/sulfamethoxazole, B) erythromycin, and C) imipramine are medications that have been associated with prolonging the QT interval and potentially leading to LQTS. Educationally, understanding the potential side effects of medications on cardiac conduction, such as prolonging the QT interval, is crucial for nurses caring for pediatric patients with cardiovascular conditions. Nurses must be able to identify medications that can cause LQTS to prevent adverse cardiac events in vulnerable populations. This knowledge informs safe medication administration practices and helps in early recognition and management of potential complications. It highlights the importance of thorough medication assessment, monitoring, and patient education to ensure safe pharmacological care in pediatric patients.

Correct Answer: D

Rationale: In this scenario, tall (>25 mm), narrow, and spiked P waves are indicative of severe mitral stenosis. This finding is known as P mitrale and is a result of left atrial enlargement due to the increased pressure in the left atrium caused by the stenotic mitral valve. Option A, Ebstein anomaly, is characterized by a congenital malformation of the tricuspid valve and displacement of the valve leaflets into the right ventricle. This condition typically presents with a wide range of ECG findings but not specifically tall, narrow, and spiked P waves. Option B, ventricular septal defect (VSD), is a congenital heart defect where there is an abnormal opening between the ventricles. This condition may lead to various ECG changes, but tall, narrow, and spiked P waves are not a typical finding associated with VSD. Option C, patent ductus arteriosus (PDA), is a congenital heart condition characterized by the persistence of the fetal connection between the aorta and pulmonary artery. ECG findings in PDA typically do not include tall, narrow, and spiked P waves. In a pediatric nursing context, understanding ECG findings specific to different cardiac conditions is crucial for early identification and management. Recognizing the ECG pattern of severe mitral stenosis can prompt timely interventions and prevent complications. Nurses caring for pediatric patients with cardiac conditions should be knowledgeable about these ECG findings to provide safe and effective care.

Correct Answer: B

Rationale: In pediatric nursing, understanding pharmacology is crucial for safe and effective patient care. In the context of this question on sildenafil, a medication commonly used for erectile dysfunction and pulmonary arterial hypertension, it is important to recognize the common side effects to monitor for adverse reactions in pediatric patients. The correct answer, B) elevated liver function tests, is not a common side effect of sildenafil. This is crucial to note as liver function should be monitored due to potential adverse effects on the liver, but elevated liver function tests are not typically associated with sildenafil use. A) Flushing is a common side effect of sildenafil due to its vasodilatory effect. C) Headache is also common, as sildenafil can cause headaches due to changes in blood flow. D) Myalgia, or muscle pain, can occur as a side effect of sildenafil due to its effects on blood flow and muscle relaxation. Educationally, this question highlights the importance of understanding common medication side effects in pediatric patients. Monitoring for and recognizing these side effects is essential for providing quality nursing care and ensuring patient safety when administering medications like sildenafil to children.

Correct Answer: B

Rationale: In pediatric nursing, understanding the appropriate timing for surgical interventions in congenital heart defects like ventricular septal defects (VSD) is crucial. The correct answer, option B, "VSD with heart failure," is considered the most appropriate for surgical repair at the time of diagnosis because significant VSDs that lead to heart failure require prompt intervention to prevent further complications and improve outcomes. Option A, "small supracristal VSD," is typically asymptomatic and may close on its own without surgical intervention. Option C, "hemodynamically restrictive VSD," implies a VSD that is not causing significant hemodynamic disturbances and can be managed conservatively with close monitoring. Option D, "significant VSD," is a broad term and does not specify the presence of heart failure, which is the key factor necessitating immediate surgical repair. Educationally, it is important for pediatric nurses to grasp the nuances of VSD management to provide optimal care for pediatric patients with congenital heart defects. Recognizing the signs of heart failure in a child with a VSD and understanding the urgency of surgical intervention in such cases can lead to better outcomes and improved patient care.