What percentage (%) of patients with rheumatic mitral valve disease has the echocardiographic diagnosis of tricuspid stenosis as a co-existing lesion?

Correct Answer: A

Rationale: In the context of pediatric cardiovascular conditions, understanding the prevalence of co-existing lesions in rheumatic mitral valve disease is crucial for effective patient management. The correct answer to the question is A) 10%. This percentage reflects the relatively lower frequency of tricuspid stenosis as a co-existing lesion in patients with rheumatic mitral valve disease. Option B) 20%, C) 30%, and D) 40% are incorrect because they overestimate the prevalence of tricuspid stenosis in this specific population. By knowing the accurate percentage, healthcare providers can make informed decisions regarding diagnostic testing, treatment strategies, and monitoring protocols for pediatric patients with rheumatic mitral valve disease. Educationally, this question highlights the importance of precision and accuracy in understanding epidemiological data related to cardiovascular conditions in pediatric patients. It emphasizes the need for healthcare providers to be well-versed in the nuances of disease presentations and co-morbidities to deliver optimal care to this vulnerable population. Understanding these statistics can guide clinical practice and improve patient outcomes by ensuring appropriate interventions are implemented based on evidence-based data.

Correct Answer: B

Rationale: The correct answer is B) “He tires out during feedings.” This statement is indicative of a potential congenital heart defect in a 1-month-old infant because infants with heart defects may have difficulty feeding due to decreased cardiac output and increased energy expenditure during feeding. This can lead to fatigue and tiring out easily during feeding sessions. Option A) “He is always hungry” is incorrect because increased hunger is not typically associated with congenital heart defects in infants. Option C) “He is fussy for several hours every day” is incorrect as fussiness alone is a common behavior in infants and not specific to heart defects. Option D) “He sleeps all the time” is also incorrect as newborns typically sleep for extended periods, and this behavior alone is not a reliable indicator of a congenital heart defect. Educationally, understanding the signs and symptoms of congenital heart defects in infants is crucial for pediatric nurses to provide early detection and intervention. Recognizing feeding difficulties and fatigue during feeding can prompt further assessment and referral for appropriate diagnostic testing and treatment, ultimately improving outcomes for infants with heart defects.

Correct Answer: D

Rationale: In infants born with hypoplastic left heart syndrome, the correct answer is D) An atrial septal defect, as this condition involves a severely underdeveloped left side of the heart, making it unable to adequately pump oxygenated blood to the body. In this situation, an atrial septal defect allows oxygenated blood from the lungs to mix with deoxygenated blood in the right atrium, providing at least some oxygenated blood to the systemic circulation. Option A) The patent ductus arteriosus is not the correct answer because this structure typically shunts blood away from the lungs in fetal circulation, which is the opposite of what is needed in hypoplastic left heart syndrome. Option B) A ventricular septal defect is unlikely to provide sufficient oxygenated blood to the systemic circulation in this condition, as it allows mixing of blood between the two ventricles rather than ensuring oxygenated blood reaches the body. Option C) The closure of the foramen ovale is not the correct answer because this structure is responsible for shunting blood between the atria in fetal circulation and is not sufficient to provide oxygenated blood to the body in hypoplastic left heart syndrome. Educationally, understanding the physiology of congenital heart defects like hypoplastic left heart syndrome is crucial for pediatric nurses to provide safe and effective care to these vulnerable patients. Recognizing the impact of specific cardiac anomalies on oxygenation and circulation helps nurses anticipate complications and intervene appropriately to optimize outcomes for these infants.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Has his weight changed in the last several days? The nurse should obtain information about the client's weight changes because in heart failure, sudden weight gain can be indicative of fluid retention, a common symptom of worsening HF. Monitoring weight is crucial in managing HF as it helps in assessing fluid status and adjusting medications accordingly to prevent exacerbations. Option A) What time did he take his last medications? While medication adherence is important, in this case, the client's symptom is more indicative of fluid retention rather than medication timing. Option C) Is he still able to tighten his belt buckle? This option is not directly related to the symptom of tight shoes and does not provide relevant information about the client's current condition. Option D) How many hours did he sleep last night? While sleep is important, it is not the priority in this situation where the client is experiencing symptoms of possible fluid retention. Educationally, this question highlights the importance of recognizing and assessing symptoms of heart failure exacerbation, emphasizing the significance of monitoring weight changes in HF patients as part of their ongoing care and management.

Correct Answer: C

Rationale: In the teaching plan for a client diagnosed with gastroesophageal reflux disease (GERD), including information on minimizing symptoms by wearing loose, comfortable clothing (option C) is crucial because tight clothing can exacerbate GERD symptoms by putting pressure on the abdomen and lower esophageal sphincter. Option A, sleeping without pillows at night to maintain neck alignment, is incorrect for GERD management because elevating the head of the bed is recommended to prevent acid reflux. Option B, adjusting food intake to three full meals per day and no snacks, is incorrect as it goes against the dietary recommendations for GERD, which include having smaller, more frequent meals and avoiding triggers like spicy foods and caffeine. Option D, avoiding participation in any aerobic exercise programs, is also incorrect as regular exercise is beneficial for managing GERD by promoting weight loss and reducing stress. Educationally, understanding the rationale behind lifestyle modifications for GERD is essential for nurses to provide comprehensive patient education and promote optimal management of the condition. By explaining the impact of clothing choices on GERD symptoms, nurses can empower clients to make informed decisions to improve their quality of life.