Which of the following is false regarding right ventricle?

Correct Answer: A

Rationale: The correct answer is A) It has fine and regular trabeculations. In the right ventricle, the trabeculae carneae are coarse and irregular, not fine and regular. Understanding the anatomical features of the heart's chambers is crucial in pediatric nursing, especially when dealing with cardiovascular disorders. Option B) Septal attachment of AV valve is more apical is true because the septal attachment of the tricuspid valve is more apical in the right ventricle compared to the mitral valve's attachment in the left ventricle. Option C) Moderator band is present is true. The moderator band is a muscular structure found in the right ventricle that carries part of the right bundle branch and helps coordinate the contraction of the heart. Option D) Trabecular septomarginalis is present is true. This structure, also known as the septomarginal trabecula, is an anatomical feature found in the right ventricle that plays a role in conducting electrical impulses. Understanding the unique anatomical features and functions of the heart's chambers is essential for pediatric nurses when assessing and managing cardiovascular disorders in young patients. Being able to correctly identify these structures can aid in providing effective care and interventions.

Correct Answer: A

Rationale: The correct answer is A) RV outflow ventricular tachycardia. In this scenario, the patient's presentation of wide QRS tachycardia with right bundle branch block (RBBB) morphology, a rate of 160 bpm, a QRS axis of (-) 40 degrees, and AV dissociation is highly indicative of RV outflow ventricular tachycardia. RV outflow ventricular tachycardia commonly presents with RBBB morphology, a leftward axis deviation, and AV dissociation due to its origin in the right ventricular outflow tract. The fast rate and wide QRS complex are consistent with this diagnosis. The other options can be ruled out based on specific characteristics: - Posterior fascicular VT typically presents with a right axis deviation, not a leftward deviation as seen in this case. - Anterior fascicular VT usually presents with a left axis deviation. - Antidromic AVRT typically does not present with RBBB morphology and AV dissociation. Understanding these distinguishing features is crucial in pediatric nursing when assessing and managing cardiovascular disorders. Recognizing the unique characteristics of different arrhythmias helps in accurate diagnosis and timely intervention, which is essential in providing effective care to pediatric patients with cardiac conditions.

Correct Answer: D

Rationale: In pediatric nursing, understanding cardiovascular disorders is crucial. The correct answer to the question, "Absent jugular venous pulsations are described in patients with the Fontan procedure," is D. Explanation of the correct answer: The Fontan procedure is a surgical intervention used in certain congenital heart defects to redirect venous blood directly to the pulmonary arteries, bypassing the right heart. This results in the absence of the typical jugular venous pulsations seen in normal circulation due to the altered hemodynamics post-surgery. Explanation of why others are wrong: A) Atrial paralysis: Atrial paralysis does not directly affect jugular venous pulsations. B) Budd Chiari syndrome: This condition involves hepatic venous outflow obstruction and is not typically associated with absent jugular venous pulsations. C) Endomyocardial fibrosis with giant right atrium: While this condition can lead to right heart enlargement, it does not specifically cause absent jugular venous pulsations. Educational context: Understanding the implications of absent jugular venous pulsations in pediatric patients post-Fontan procedure is essential for nurses caring for these individuals. It signifies the altered physiology and circulation resulting from the surgical correction, highlighting the importance of monitoring these patients closely for any signs of complications or hemodynamic changes.

Correct Answer: A

Rationale: In a neonate, an ejection systolic murmur in outflow is least likely to be due to a subaortic membrane. This is because subaortic membrane is a rare congenital heart defect that typically presents with a harsh systolic murmur on the left sternal border, not in the outflow tract. Unicuspid and bicuspid aortic valves are associated with aortic stenosis or regurgitation, which can cause an ejection systolic murmur in the outflow tract. Pulmonary stenosis can also lead to an ejection systolic murmur, as it obstructs the flow of blood from the right ventricle to the pulmonary artery. Educationally, understanding the etiology of murmurs in pediatric cardiovascular disorders is crucial for nurses caring for neonates. Recognizing the different causes of murmurs helps in early detection, appropriate intervention, and collaboration with the healthcare team to provide optimal care for these vulnerable patients.

Correct Answer: D

Rationale: The drug of choice for infective endocarditis due to HACEK (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, Kingella species) organisms is D) Ceftriaxone. Ceftriaxone is a third-generation cephalosporin with excellent coverage against Gram-negative organisms like those in the HACEK group. It also has good tissue penetration, making it effective in treating infective endocarditis. A) Vancomycin is a glycopeptide antibiotic used for Gram-positive infections, particularly for MRSA (Methicillin-resistant Staphylococcus aureus), not typically HACEK organisms. B) Gentamicin is an aminoglycoside antibiotic mainly used in combination therapy for serious Gram-negative infections, not usually a first-line choice for infective endocarditis due to HACEK organisms. C) Ampicillin is a penicillin-based antibiotic effective against certain Gram-positive and Gram-negative bacteria but is not the first-line choice for HACEK organisms causing infective endocarditis. Understanding the specific antimicrobial coverage for different organisms causing infective endocarditis is crucial in providing effective treatment and preventing complications. It is essential for pediatric nurses to have a sound knowledge of pharmacology to ensure safe and effective medication administration in pediatric patients with cardiovascular disorders.