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

Correct Answer: B

Rationale: In pediatric nursing, understanding the characteristics of large ventricular septal defects (VSD) is crucial for providing optimal care. The correct answer, option B, "Symptoms appear within 1-3 months," is accurate because infants born with large VSDs often present with symptoms like poor feeding, failure to thrive, and respiratory distress 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 the volume overload in the left side of the heart caused by the shunting of blood from the left ventricle to the right ventricle. Option C, "Diastolic murmur," is also incorrect as VSD typically presents with a harsh, holosystolic murmur along the left sternal border due to the turbulent blood flow across the defect during systole. Option D, "Normal pulmonary venous markings," is incorrect because large VSDs can lead to increased pulmonary blood flow, resulting in pulmonary congestion and prominent pulmonary vascular markings on chest X-ray due to the increased blood flow to the lungs. Educationally, knowing these distinctions is vital for nurses caring for pediatric patients with congenital heart defects. Recognizing the signs and symptoms of large VSDs early can lead to prompt intervention and improved outcomes for these vulnerable patients. It underscores the importance of thorough assessment, early detection, and collaboration with the healthcare team to provide comprehensive care for infants with cardiac anomalies.

Correct Answer: B

Rationale: In iron deficiency anemia, the erythrocytic indices are typically as follows: MCV (Mean Corpuscular Volume) decreased, MCH (Mean Corpuscular Hemoglobin) decreased, and MCHC (Mean Corpuscular Hemoglobin Concentration) decreased. This is because iron deficiency leads to smaller, hypochromic red blood cells. Option A is incorrect because in iron deficiency anemia, MCV is decreased, not increased. Option C is incorrect because MCH is decreased in iron deficiency anemia, not increased. Option D is incorrect because MCHC is decreased in iron deficiency anemia, not normal. Educationally, understanding the erythrocytic indices in different types of anemia is crucial for pediatric nurses to accurately assess and manage patients. Recognizing the specific patterns associated with iron deficiency anemia helps in making appropriate clinical decisions, such as initiating iron supplementation and monitoring treatment effectiveness. This knowledge is essential in providing quality care to pediatric patients with anemia.

Correct Answer: D

Rationale: The correct answer is D) Ethambutol. Ethambutol is known to cause optic neuritis as a side effect, which can lead to visual disturbances and changes in color perception. This occurs due to its toxic effect on the optic nerve. Option A) Isoniazid is an antituberculosis agent that is associated with peripheral neuropathy, especially in patients with pre-existing conditions like diabetes. It does not typically cause optic neuritis. Option B) Rifampin is another antituberculosis agent that is more commonly associated with hepatotoxicity and gastrointestinal disturbances rather than optic neuritis. Option C) Pyrazinamide is known for its hepatotoxic effects and can cause hyperuricemia, arthralgia, and myalgia but is not typically linked to optic neuritis. In pediatric nursing, understanding the potential side effects of medications is crucial for safe and effective patient care. Recognizing the side effects of antituberculosis agents, such as optic neuritis from Ethambutol, helps nurses monitor and manage these adverse effects promptly. This knowledge also aids in patient education and adherence to treatment plans.

Correct Answer: B

Rationale: The correct answer is B) Enteroviruses. Encephalitis is inflammation of the brain typically caused by viral infections. Enteroviruses are the most common viral cause of encephalitis in children. They are known to affect the central nervous system, leading to symptoms such as fever, headache, and in severe cases, neurological complications. Option A) Herpes simplex is a common cause of encephalitis in adults, but it is less common in children. Varicella Zoster (Option C) is associated with chickenpox and shingles, not typically encephalitis. Mumps (Option D) is more commonly associated with parotitis and orchitis rather than encephalitis. In a pediatric nursing context, understanding the common causes of encephalitis is crucial for early recognition and appropriate management. Knowing that enteroviruses are a frequent culprit in pediatric encephalitis helps nurses prioritize assessments, interventions, and education for both the child and their caregivers. It also highlights the importance of vaccination and preventive measures to reduce the risk of viral infections leading to serious neurological complications in children.

Correct Answer: C

Rationale: In pediatric nursing, understanding the complications of common childhood infections like mumps is crucial for providing effective care. The correct answer is C) Meningoencephalitis. Meningoencephalitis, inflammation of the brain and its surrounding membranes, is a serious complication of mumps that can lead to neurological problems, seizures, and even death. This is because the mumps virus can spread to the central nervous system, causing significant damage. Option A) Arthritis is not the most common complication of mumps. While mumps can sometimes lead to joint pain and swelling, arthritis is not the primary concern associated with this infection. Option B) Nephritis, inflammation of the kidneys, is not a typical complication of mumps. Mumps primarily affects the salivary glands and can lead to complications in other organs, but nephritis is not commonly associated with mumps. Option D) Thyroiditis, inflammation of the thyroid gland, is not a common complication of mumps infection. Mumps typically affects the parotid glands, and while it can affect other organs, thyroiditis is not a primary concern in mumps cases. Educationally, understanding the complications of mumps helps healthcare providers anticipate and manage potential issues that may arise in pediatric patients. By knowing that meningoencephalitis is a serious complication of mumps, nurses and other healthcare professionals can monitor for neurological symptoms and intervene promptly to prevent serious consequences. This knowledge is vital in providing comprehensive care to pediatric patients with mumps and ensuring positive outcomes.