The most common congenital cyanotic heart disease in newborn is:

Correct Answer: C

Rationale: In pediatric nursing, understanding congenital heart diseases is crucial for providing safe and effective care to newborns. The correct answer to the question is C) d-Transposition of great arteries. d-Transposition of the great arteries is the most common congenital cyanotic heart disease in newborns. In this condition, the aorta arises from the right ventricle, and the pulmonary artery arises from the left ventricle, leading to two separate circulatory systems. This results in severe cyanosis shortly after birth, requiring prompt medical intervention. Option A) Tetralogy of Fallot is a cyanotic heart defect characterized by four components: pulmonary stenosis, overriding aorta, ventricular septal defect, and right ventricular hypertrophy. While it is a common congenital heart defect, it is not the most common cyanotic heart disease in newborns. Option B) Ebstein anomaly is a rare congenital heart defect characterized by the displacement of the tricuspid valve into the right ventricle. It is not typically associated with cyanosis in newborns. Option D) Hypoplastic left heart syndrome is a severe congenital heart defect where the left side of the heart is underdeveloped. While it can present with cyanosis, it is not as common as d-Transposition of the great arteries in newborns. Understanding the prevalence, pathophysiology, and clinical manifestations of congenital heart diseases in newborns is essential for pediatric nurses to recognize early signs, provide appropriate care, and collaborate with the healthcare team to optimize outcomes for these vulnerable patients.

Correct Answer: C

Rationale: The correct answer is C) Pruritic erythematous rash over the face. This is not a major manifestation of acute rheumatic fever. In acute rheumatic fever, major manifestations typically involve the heart, joints, skin, and central nervous system. Option A) Involuntary purposeless, jerky dysrhythmic movement of hands and arms is known as Sydenham's chorea and is a major manifestation of acute rheumatic fever. Option B) Swollen tender large joint is a common symptom seen in acute rheumatic fever, known as migratory polyarthritis. Option D) Auscultation of a new apical pansystolic murmur in a previously normal heart is a classic finding in acute rheumatic fever due to carditis. In an educational context, understanding the major manifestations of acute rheumatic fever is crucial for pediatric nurses to provide timely and accurate care to affected children. Recognizing these signs and symptoms can lead to early detection and appropriate management to prevent complications such as rheumatic heart disease. It is essential for healthcare professionals to be well-versed in the distinguishing features of acute rheumatic fever to ensure optimal patient outcomes.

Correct Answer: D

Rationale: The correct answer is D) Shift of the mediastinum to the right side in expiratory film. When a foreign body partially obstructs the left main bronchus, it can cause air trapping in the left lung, leading to hyperinflation and subsequent mediastinal shift to the right side during expiration. This occurs because the obstructed lung cannot fully exhale air, causing the mediastinum to shift towards the contralateral side. Option A) Increased air entry on the left hemithorax is incorrect because partial obstruction would not result in increased air entry but rather decreased air entry due to the blockage. Option B) Homogenous opacity of the right hemithorax on CXR is incorrect as it does not correlate with a foreign body in the left bronchus. Opacity typically indicates fluid or tissue, not a foreign body obstruction. Option C) Hyperinflated right hemithorax on CXR is also incorrect because the hyperinflation would occur in the obstructed lung (left side) due to air trapping, not in the contralateral lung. Understanding the radiological findings associated with bronchial foreign body obstruction is crucial in pediatric nursing. Recognizing these abnormalities can aid in prompt diagnosis and intervention, preventing potential complications such as respiratory distress and lung collapse. Nurses caring for pediatric patients with suspected foreign body aspiration should be knowledgeable about interpreting chest X-rays and understanding the implications of different radiological findings.

Correct Answer: A

Rationale: Neonatal Respiratory Distress Syndrome (RDS) is primarily caused by surfactant deficiency. Surfactant is a substance produced by the alveoli in the lungs that helps keep the air sacs open and prevents them from collapsing. In premature infants, the lungs may not have produced enough surfactant, leading to respiratory distress. This deficiency is the main reason for RDS in neonates. Option B, congenital pneumonia, is not the primary cause of RDS. While pneumonia can cause respiratory distress in neonates, it is not the main etiology of RDS. Option C, persistent pulmonary hypertension, is a condition where the blood vessels in the lungs remain constricted, making it harder for blood to flow through the lungs and pick up oxygen. While it can lead to respiratory distress, it is not the primary cause of RDS. Option D, meconium aspiration, occurs when a newborn inhales meconium (the infant's first stool) into the lungs, which can cause respiratory problems. However, it is not the primary cause of RDS. Understanding the primary causes of neonatal RDS is crucial for pediatric nurses as they care for preterm infants who are at risk for this condition. Proper education on the importance of surfactant in lung function and the risk factors for RDS can help nurses provide optimal care and support for these vulnerable patients.

Correct Answer: D

Rationale: Intraventricular hemorrhage (IVH) in preterm infants is a serious condition that occurs due to the fragility of blood vessels in the developing brain. The major risk factor for IVH in preterm infants is prematurity (Option D). Prematurity is the correct answer because the blood vessels in the brain of preterm infants are not fully developed, making them more susceptible to bleeding. The immature blood vessels are unable to withstand the rapid changes in blood flow and pressure that occur outside the womb, leading to IVH. Option A, maternal hypertension, is not a major risk factor for IVH in preterm infants. While maternal hypertension can lead to other complications during pregnancy, it is not directly linked to IVH. Option B, low Apgar scores, may indicate the need for immediate medical attention after birth but is not a direct risk factor for IVH. Apgar scores assess the baby's overall health at birth based on heart rate, respiratory effort, muscle tone, reflex irritability, and color. Option C, high birth weight, is not a major risk factor for IVH in preterm infants. In fact, IVH is more commonly associated with low birth weight and prematurity due to the underdeveloped blood vessels in preterm infants. In an educational context, understanding the risk factors for IVH in preterm infants is crucial for nurses and healthcare providers working in neonatal care. Recognizing the impact of prematurity on the risk of IVH can help in early identification, monitoring, and management of at-risk infants to prevent or minimize complications associated with this condition.