Question 1:
The lymphatic ducts drain into the:
arterial system.
venous system. Correct
arteriovenous system.
capillary bed.
... [Show More] Incorrect
Explanation:
The lymphatic ducts drain into the venous system.
Question 2:
While auscultating the patient's heart, a medium, soft murmur is audible. It is pansystolic and heard
loudest at the apex with radiation to the left axilla. These findings are consistent with:
tricuspid regurgitation.mitral regurgitation. Correcta ventricular septal defect.an innocent
murmur. Incorrect
Explanation:
Mitral regurgitation produces a pansystolic, harsh murmur heard loudest at the apex with radiation
toward the left axilla. The intensity of the murmur can be soft or if there is an atrial thrill, it can be loud.
With tricuspid regurgitation, the murmur is audible loudest at the left sternal border with radiation to
the right sternal border, xiphoid area, or to the left midclavicular line. It produces a blowing sound and is
pansystolic. The murmur of an uncomplicated ventricular septal defect has a high pitch and is usually
heard throughout systole. An innocent murmur is heard loudest at mid systole near the second to fourth
intercostal spaces between the left sternal border and the apex. It usually decreases or disappears when
sitting.
Question 3:
Which of the following group of symptoms would be suggestive of an infant experiencing a congenital
heart defect associated with a decreased pulmonary blood flow pattern?
Tissue perfusion greater than 3 seconds, bluish colored skin, and poor feeding Correct
Abnormal heart sounds, capillary refill less than 2 seconds, and oxygen saturation less than 95%
Capillary refill less than 2 seconds, tissue perfusion less than 3 seconds, and oxygen saturation greater
than 95%
Poor feeding, audible heart murmur, and oxygen saturation greater than 95%Explanation:
Infants with defects resulting from decreased pulmonary blood flow have cyanosis because of
desaturated blood entering systemic circulation and/or because of the inability to get blood to the lungs.
Tetralogy of Fallot (TOF), pulmonary atresia and tricuspid atresia all fall in this category and are
considered cyanotic defects. Due to the ventricular septal defect in TOF, the absence of the tricuspid
valve or pulmonary valve in tricuspid and pulmonary atresia, one should hear abnormal heart sounds
either due to the murmur in TOF or single heart sounds of S1 or S2 in pulmonary atresia or tricuspid
atresia. Usually these infants have activity intolerance and therefore, experience failure to thrive because
of their inability to consume enough formula to gain weight appropriately. Capillary refill is usually
prolonged due to poor oxygenation and poor perfusion secondary to the defect as well as the O2 sats
being lower than normal, sometimes even in the 80% range.
Question 4:
Right atrial pressure can be determined by:
palpating the carotid pulse. Incorrect
identifying the pulsations of the right jugular vein. Correct
analyzing the arterial blood gases.
assessing for dependent edema.
Explanation:
Jugular venous pressure reflects pressure in the right atrium and is best assessed from pulsations in the
right internal jugular vein. This is an indicator of cardiac function and right heart hemodynamics.
Palpating the carotid artery denotes arterial pressure; analyzing blood gases reflects the status of the
arterial blood. Assessing for dependent edema is a reflection of heart failure and poor venous return and
not atrial pressure.
Question 5:
When assessing the heart rate of a healthy 13-month-old child, which one of the following sites is the
most appropriate for this child? [Show Less]