Which is true regarding large ventricular septal defect (VSD)?

Correct Answer: B

Rationale: In pediatric nursing, understanding congenital heart defects like ventricular septal defects (VSD) is crucial. The correct answer is B) Symptoms appear within 1-3 months. This is because large VSDs often lead to symptoms like poor feeding, failure to thrive, respiratory infections, and heart failure within the first few months of life due to the significant left-to-right shunting of blood. Option A) Right apical impulse is incorrect because in VSD, the apical impulse is usually displaced to the left due to left ventricular enlargement. Option C) Diastolic murmur is incorrect because VSD typically presents with a holosystolic murmur along the left sternal border due to the increased flow across the defect during systole. Option D) Normal pulmonary venous markings is incorrect because in large VSD, there may be increased pulmonary blood flow leading to pulmonary congestion and prominent pulmonary vascular markings on imaging. Educationally, understanding the characteristic signs and symptoms of large VSDs is vital for early identification and management in pediatric patients. Nurses need to be able to recognize these clinical manifestations to provide prompt interventions and prevent complications associated with untreated VSDs.

Correct Answer: B

Rationale: In iron deficiency anemia, the erythrocytic indices are typically characterized by microcytic (decreased MCV), hypochromic (decreased MCH), and hypochromic (decreased MCHC) red blood cells. This is due to the insufficient hemoglobin synthesis caused by the lack of iron. Option B is correct as it reflects these characteristic changes associated with iron deficiency anemia. Option A is incorrect because in iron deficiency anemia, MCV is decreased due to the smaller size of red blood cells, and MCH and MCHC are both decreased due to the reduced hemoglobin content in each cell. Option C is incorrect because in iron deficiency anemia, MCV is decreased, MCH is decreased, and MCHC is decreased. MCH would not be increased in this case. Option D is incorrect as MCV is decreased, MCH is decreased, and MCHC is decreased in iron deficiency anemia, so stating that MCHC is normal is inaccurate. Understanding the characteristic erythrocytic indices in iron deficiency anemia is crucial for nurses caring for pediatric patients as it helps in identifying and managing this common condition in children. By knowing these indices, nurses can provide appropriate interventions such as iron supplementation and dietary modifications to improve the child's health outcomes.

Correct Answer: D

Rationale: The correct answer is D) Ethambutol. Ethambutol is known to cause optic neuritis, which is inflammation of the optic nerve leading to visual disturbances. This adverse effect is unique to ethambutol among the options provided. A) Isoniazid is a commonly used antituberculosis agent but is not associated with causing optic neuritis. B) Rifampin is another widely used antituberculosis drug but does not typically lead to optic neuritis. C) Pyrazinamide is not known to cause optic neuritis. In a pediatric nursing context, understanding the potential side effects of medications used in the treatment of tuberculosis is crucial for providing safe and effective care to young patients. Recognizing the adverse effects of ethambutol, such as optic neuritis, allows nurses to monitor for symptoms, intervene promptly if needed, and educate patients and families on what to watch for during treatment.

Correct Answer: B

Rationale: In pediatric nursing, understanding the etiology of encephalitis is crucial for providing appropriate care. The correct answer is B) Enteroviruses. Enteroviruses are the most common viral cause of encephalitis in children due to their neurotropic nature, leading to central nervous system involvement. These viruses can cause a range of neurological symptoms in children, making them a significant concern in pediatric healthcare. Option A) Herpes simplex is a common cause of viral encephalitis in adults but is less prevalent in pediatric cases. Option C) Varicella Zoster typically presents as chickenpox or shingles and is not a common cause of encephalitis. Option D) Mumps can cause complications like meningitis but is not a primary cause of encephalitis in children. Educationally, this question reinforces the importance of recognizing the specific viral causes of encephalitis in pediatric patients. Understanding the common pathogens involved allows nurses to promptly identify symptoms, provide appropriate treatment, and prevent potential complications in pediatric patients with suspected encephalitis. This knowledge empowers nurses to deliver effective and timely care, ultimately improving patient outcomes in pediatric neurology cases.

Correct Answer: C

Rationale: In the context of pediatric nursing, understanding the complications of infectious diseases like mumps is crucial for providing optimal care to children. The correct answer to the question, "The most common complication of mumps infection is:" is C) Meningoencephalitis. Meningoencephalitis is the most common complication of mumps infection because the mumps virus primarily affects the salivary glands but can also lead to inflammation of the meninges and brain tissue. This can result in symptoms such as headache, fever, and in severe cases, seizures and neurological deficits. Option A) Arthritis is not a common complication of mumps infection. Mumps primarily affects the salivary glands and does not typically lead to joint inflammation. Option B) Nephritis involves inflammation of the kidneys and is not a common complication of mumps infection. Mumps does not typically target the kidneys. Option D) Thyroiditis, inflammation of the thyroid gland, is not a common complication of mumps infection. Mumps primarily affects the salivary glands and does not commonly involve the thyroid. Educationally, this question highlights the importance of understanding the potential complications of infectious diseases in pediatric patients. It reinforces the need for healthcare providers to be able to recognize and manage complications such as meningoencephalitis in children with mumps to provide appropriate care and prevent further complications.