Which of the following is a common sign of acyanotic congenital heart defects in pediatric patients?
Heart murmur.
Cyanosis.
Severe hypoxia.
Peripheral edema.
The Correct Answer is A
Understanding acyanotic congenital heart defects involves recognizing conditions where oxygenated blood recirculates through the lungs. The nurse must apply knowledge of how abnormal openings or narrowings create turbulent blood flow, which is detected through specific physical assessment findings like murmurs.
Choice A rationale
Acyanotic defects, such as VSD or ASD, involve left-to-right shunting that creates audible turbulence. This turbulence is manifested as a heart murmur, which is often the first clinical sign found during a routine physical examination of the child.
Choice B rationale
Cyanosis is the hallmark of cyanotic heart defects where deoxygenated blood enters the systemic circulation. In acyanotic defects, systemic oxygen saturation remains within the normal range of 95.
Choice C rationale
Severe hypoxia is characteristic of right-to-left shunts where pulmonary blood flow is obstructed or bypassed. Patients with acyanotic defects usually maintain adequate systemic oxygen levels and do not exhibit the severe respiratory distress associated with profound hypoxia.
Choice D rationale
Peripheral edema is a sign of congestive heart failure, which can eventually occur as a complication of acyanotic defects. However, it is not an immediate or common initial sign of the congenital defect itself in many pediatric cases.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Bronchiolitis is an acute viral infection of the lower respiratory tract characterized by inflammation and mucus production. Understanding the epidemiology of pediatric respiratory pathogens is vital for implementing appropriate isolation precautions and managing airway obstruction caused by edema and cellular debris.
Choice A rationale
Respiratory syncytial virus is the primary causative agent in over 75 percent of bronchiolitis cases. It causes necrosis of the bronchiolar epithelium and increased mucus production, leading to the characteristic wheezing and air trapping seen in infants.
Choice B rationale
While COVID-19 can cause respiratory distress in children, it is not the most common cause of the specific clinical syndrome known as bronchiolitis. COVID-19 typically presents with broader systemic symptoms or different patterns of pulmonary involvement in infants.
Choice C rationale
Influenza virus can cause lower respiratory tract infections, but it typically presents with higher fever and more significant systemic malaise. It accounts for a much smaller percentage of bronchiolitis cases compared to the prevalence of RSV.
Choice D rationale
Bronchiolitis is almost exclusively a viral syndrome. While bacterial superinfections can occur, primary bacterial organisms are not the cause of the bronchiolar inflammation and mucus plugging that define the pathophysiology of bronchiolitis in children under age two.
Correct Answer is C
Explanation
This question assesses knowledge of pediatric growth and development milestones for a toddler transitioning into the preschool stage. Application of physical, cognitive, and language development standards for a thirty-six-month-old child is required to distinguish normal findings from abnormal neurological or developmental delays.
Choice A rationale
The Babinski reflex, where the big toe dorsiflexes, should disappear by twenty-four months of age as the corticospinal tract matures. Its presence at age three is abnormal and suggests a central nervous system lesion or delayed neurological development.
Choice B rationale
Hopping on one foot is a gross motor skill usually mastered at age four. While some three-year-olds may attempt it, it is not the standard developmental expectation for this age group, who are more adept at riding tricycles.
Choice C rationale
By age three, children typically have a vocabulary of about nine hundred words and use three-word to four-word sentences. This linguistic milestone reflects normal cognitive and social development, allowing the child to communicate basic needs and observations effectively.
Choice D rationale
The absence of stranger anxiety is not a standard physical or developmental finding at this age. While it peaks earlier, children at age three still demonstrate clear preferences for primary caregivers and may show wariness toward unfamiliar individuals.
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