Auscultation of a 3 year-old child's heart reveals a pansystolic, harsh murmur. It is heard loudest over the lower left sternal border. This finding is consistent with a:
pericardial friction rub.
venous hum.
patent ductus arteriosus.
ventricular septal defect.
The Correct Answer is D
Rationale:
A. A pericardial friction rub is a scratching or grating sound caused by inflammation of the pericardium and is not typically described as a pansystolic murmur.
B. A venous hum is a continuous, low-pitched sound heard over the neck and upper chest, not a harsh pansystolic murmur at the lower left sternal border.
C. A patent ductus arteriosus usually produces a continuous “machinery-like” murmur rather than a pansystolic murmur.
D. A ventricular septal defect (VSD) often presents as a pansystolic, harsh murmur best heard at the lower left sternal border. The intensity of the murmur may vary with the size of the defect, but this location and quality are classic for VSD in a young child.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Limiting fats is inappropriate for children with cystic fibrosis (CF) because they require a high-calorie, high-fat diet to maintain growth due to malabsorption.
B. Increasing calories by 50% is appropriate, but limiting salt is not recommended; children with CF often require extra salt due to excessive losses in sweat.
C. While vitamins are important, CF patients require fat-soluble vitamins (A, D, E, K) rather than B complex and C specifically.
D. Adding pancreatic enzymes four to five times a day is essential for children with CF who have pancreatic insufficiency. These enzymes aid in digestion and absorption of nutrients, improving growth and nutritional status.
Correct Answer is D
Explanation
Rationale:
A. While perinatal mortality is higher in preterm infants compared with term infants, it is a consequence rather than a direct risk factor.
B. Asphyxia can occur in both term and preterm infants and is not specific to prematurity.
C. Cardiovascular complications may arise but are only one aspect of the broader risks associated with prematurity.
D. Prematurity-related complications encompass the full spectrum of health risks preterm infants face, including respiratory distress syndrome, intraventricular hemorrhage, thermoregulation difficulties, feeding intolerance, and infection susceptibility. These complications are directly related to the immaturity of organ systems in infants born before 37 weeks’ gestation, making them the most comprehensive risk category.
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