A 3-year-old child with congestive heart failure resulting from an underlying congenital heart defect, is prescribed digoxin and furosemide. Which of the following assessment findings are MOST concerning?

A blood pressure of 100/56 and a small weight gain

A heart rate of 150 beats/minute with crying

An apical pulse of 70 beats/minute and vomiting

An hourly urine output of 45mL/hour

Answer and Explanation

The Correct Answer is C

A. A blood pressure of 100/56 and a small weight gain may indicate fluid retention, but they are not immediately life-threatening.
B. A heart rate of 150 beats/minute with crying can be normal for a child of this age, especially during emotional distress.
C. An apical pulse of 70 beats/minute and vomiting are concerning because they may indicate digoxin toxicity. A low heart rate (bradycardia) in a child on digoxin requires immediate attention.
D. An hourly urine output of 45 mL/hour is adequate and not concerning in this context.

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Correct Answer is C

Explanation

A. A basic metabolic panel is a blood test that measures various substances in the blood, but it is not used to determine the extent of tumor metastasis.
B. A lumbar puncture can be used to detect cancer cells in the cerebrospinal fluid, but it does not provide a full picture of metastasis.
C. A head CT (computed tomography) scan is a valuable imaging test that can help determine the extent of tumor metastasis, particularly to the brain or skull.
D. A biopsy is used to diagnose the type of tumor but is not typically used to determine the extent of metastasis on its own.

A. Vomiting B. Poor Feeding C. Weak cry D. Sunken Fontanels E. Irritability

Correct Answer is ["A","B","E"]

Explanation

A. Vomiting can be a sign of increased intracranial pressure (ICP).
B. Poor feeding is a concerning symptom of increased ICP.
C. A weak cry may indicate general illness but is not specifically indicative of increased ICP.
D. Sunken fontanels suggest dehydration, not increased ICP. Bulging fontanels would be concerning for increased ICP.
E. Irritability can be a sign of increased ICP in infants.

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A 3-year-old child with congestive heart failure resulting from an underlying congenital heart defect, is prescribed digoxin and furosemide. Which of the following assessment findings are MOST concerning?

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Naxlex Comprehensive Predictor Exams

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