Ventricular tachycardia (VT) is defined as at least 3 premature ventricular contractions PVCs at >120 beats/min. Hemodynamically unstable patients with VT should be immediately treated with

Correct Answer: C

Rationale: In pediatric cardiovascular nursing, understanding the management of ventricular tachycardia (VT) is crucial for providing safe and effective care to hemodynamically unstable patients. The correct immediate treatment for hemodynamically unstable patients with VT is option C) DC cardioversion. DC cardioversion is the appropriate choice in this scenario because it helps restore the heart's normal sinus rhythm quickly and effectively in cases of unstable VT. This intervention is essential in preventing further deterioration of the patient's hemodynamic status and reducing the risk of complications such as cardiac arrest. The other options are not the first-line treatment for hemodynamically unstable VT in pediatric patients. A) Catheter ablation is a treatment option for certain types of arrhythmias but is not the immediate intervention for unstable VT. B) Implantable cardioverter-defibrillator (ICD) implantation is a long-term management strategy for preventing sudden cardiac death but is not the initial treatment for acute hemodynamically unstable VT. D) Amiodarone is a medication used for stable VT, not for immediate management of unstable VT where prompt intervention like cardioversion is needed. Educationally, understanding the appropriate interventions for pediatric cardiovascular emergencies like VT is essential for nurses working in pediatric cardiology units or emergency departments. This knowledge ensures timely and effective care delivery, ultimately improving patient outcomes and safety. It underscores the importance of quick decision-making and prioritizing interventions based on the patient's hemodynamic stability.

Correct Answer: C

Rationale: In pediatric cardiovascular nursing, understanding hypertension in children is crucial for early detection and management. The correct definition of hypertension in children being "average systolic blood pressure (SBP) and/or diastolic BP that is ≥95th percentile for age, sex, and height on ≥3 occasions" (Option C) is based on current pediatric guidelines. This definition emphasizes the importance of considering the child's age, sex, and height in determining hypertension, as these factors influence blood pressure norms in children. Option A is incorrect because it does not include height, which is an essential factor in determining blood pressure percentiles in children. Option B is incorrect because it mentions "on ≥2 occasions," whereas multiple readings across three separate occasions are necessary to diagnose hypertension accurately in children. Option D is incorrect as it sets the threshold at the 90th percentile, which is below the standard definition for pediatric hypertension. Educationally, this question highlights the precision required in diagnosing hypertension in children and underscores the need for healthcare providers to follow established guidelines for accurate assessment. Understanding the nuances of blood pressure measurements in pediatric patients is vital for providing optimal care and preventing long-term cardiovascular complications.

Correct Answer: C

Rationale: In pediatric cardiovascular nursing, understanding ECG findings is crucial for accurate assessment and management of cardiac conditions. In this scenario, the correct answer is C) RBBB in Ebstein anomaly. Ebstein anomaly is a rare congenital heart defect characterized by malformation of the tricuspid valve, leading to displacement of the valve leaflets into the right ventricle. This displacement can result in right bundle branch block (RBBB) on ECG due to the altered conduction pathways in the right ventricle. Option A) Bifid P waves in large VSD (ventricular septal defect) is incorrect because VSD typically presents with a wide fixed split S2 on auscultation, not bifid P waves on ECG. Option B) Complete heart block in cyanotic attacks of Tetralogy of Fallot is incorrect as complete heart block is not a typical ECG finding in Tetralogy of Fallot. Cyanotic spells in Tetralogy of Fallot are usually associated with decreased pulmonary blood flow and increased right-to-left shunting. Option D) Right axis deviation in tricuspid atresia is incorrect because tricuspid atresia is characterized by cyanosis and a right-to-left shunt, but it typically presents with left axis deviation on ECG due to right ventricular hypertrophy and leftward shift of the heart. Understanding these ECG findings in pediatric cardiovascular conditions is essential for nurses and healthcare providers to provide safe and effective care to pediatric patients with cardiac anomalies.

Correct Answer: C

Rationale: In the context of pediatric cardiovascular nursing and the association between Down syndrome and ventricular septal defect (VSD), option C, "Pulmonary Hypertension is a late complication," is the correct answer. The rationale behind this is that children with Down syndrome are at an increased risk of congenital heart defects, with VSD being one of the most common. Over time, if a VSD is left untreated or not closed surgically, it can lead to increased blood flow to the lungs, causing pulmonary hypertension as a late complication. This occurs due to the increased workload on the right side of the heart, leading to elevated pressures in the pulmonary circulation. Option A, stating that the VSD doesn't close spontaneously as in children without Down syndrome, is incorrect. VSDs in children with or without Down syndrome may close spontaneously, but if they persist, they can lead to complications. Option B, mentioning that an inaudible murmur is a characteristic feature or that the murmur is not audible, is incorrect. Murmurs associated with VSDs are typically audible on auscultation due to the turbulent blood flow across the defect. Option D, suggesting that if there is no murmur, the condition need not be investigated, is also incorrect. The absence of a murmur does not rule out the presence of a VSD, as some defects may be small and not produce a murmur. In an educational context, understanding the relationship between Down syndrome and congenital heart defects like VSD is crucial for pediatric nurses to provide comprehensive care to these vulnerable patients. Recognizing the potential complications such as pulmonary hypertension allows for early intervention and management, highlighting the importance of regular cardiac assessments and monitoring in children with Down syndrome.

Correct Answer: C

Rationale: In pediatric cardiovascular nursing, understanding the implications of different cardiac conditions on exercise tolerance is crucial. In this scenario, the correct answer is C) Aortic stenosis. Aortic stenosis is a congenital heart defect characterized by narrowing of the aortic valve, leading to decreased cardiac output. During vigorous exercise, the heart has to work harder to meet the increased demand for oxygen, which can exacerbate the effects of aortic stenosis and potentially lead to cardiac complications like arrhythmias or syncope. Option A) Prolonged QT interval is a risk factor for arrhythmias but does not directly contraindicate vigorous exercise. Option B) Maladie de Roger deformity is a rare congenital heart condition and its impact on exercise tolerance is not well-documented, making it a less likely choice. Option D) Bicuspid aortic valve is a common congenital heart defect, but unless it is causing significant aortic stenosis, it does not necessarily require avoidance of vigorous exercise. Educationally, this question highlights the importance of understanding how different cardiac conditions can impact exercise tolerance in pediatric patients. It emphasizes the need for nurses to recognize when certain activities should be limited to ensure the safety and well-being of their patients with cardiovascular issues.