The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, "Why do my child's fingertips look like that?" On what understanding does the nurse base a response?
Clubbing occurs as a result of decreased cardiac output.
Clubbing occurs as a result of a left-to-right shunting of blood.
Clubbing occurs as a result of chronic hypoxia
Clubbing occurs as a result of untreated congestive heart failure.
The Correct Answer is C
C. Clubbing, characterized by bulbous enlargement of the fingertips and nail bed, is a result of chronic hypoxia in tetralogy of Fallot. In tetralogy of Fallot, there is a right-to-left shunting of blood due to the presence of a ventricular septal defect, overriding aorta, pulmonary stenosis, and right ventricular hypertrophy. This leads to reduced oxygenation of blood and chronic hypoxia, which can result in clubbing of the fingertips over time.
A This option is not the primary explanation for clubbing in tetralogy of Fallot. While decreased cardiac output may contribute to some manifestations of the condition, clubbing specifically results from chronic hypoxia rather than decreased cardiac output alone.
B Clubbing is not directly caused by a left-to-right shunting of blood. Instead, it is associated with chronic hypoxia, which can occur due to right-to-left shunting of blood in tetralogy of Fallot.
D Congestive heart failure may occur in individuals with tetralogy of Fallot but it is not the primary cause of clubbing. Clubbing in tetralogy of Fallot is primarily attributed to chronic hypoxia rather than heart failure alone.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This is a common postictal manifestation after a generalized tonic-clonic seizure. Following the intense muscle activity and convulsions during the seizure, the child may experience exhaustion and feel sleepy. The postictal state often involves a period of drowsiness or even brief loss of consciousness.
B. Restlessness is less likely to be observed immediately after a generalized tonic-clonic seizure. Instead, the child is more likely to exhibit fatigue and lethargy as the body recovers from the seizure activity.
C. Anxiety may occur during or immediately after the seizure due to the sudden and frightening nature of the event. However, in the postictal period, anxiety typically diminishes as the child becomes more oriented and aware of their surroundings.
D. Nausea is not a typical postictal manifestation after a generalized tonic-clonic seizure. While some individuals may experience nausea or vomiting during the seizure (ictal phase), it is less common in the postictal period.
Correct Answer is A
Explanation
A. Nausea and vomiting are potential adverse effects of digoxin in children. Digoxin is a medication commonly used to treat heart conditions, but it can cause gastrointestinal disturbances as a side effect. Nausea and vomiting may occur, especially if the child is receiving too high a dose of digoxin or if they are particularly sensitive to the medication.
B. Improved appetite would not typically indicate an adverse effect of digoxin. In fact, digoxin is not known to have a direct effect on appetite. If a child experienced an increase in appetite while taking digoxin, it would likely be unrelated to the medication or could be due to other factors.
C. Increased urine output would not typically indicate an adverse effect of digoxin. Digoxin is not a diuretic medication, so it would not directly cause increased urine output.
D. Digoxin is not commonly associated with bradycardia in children.
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