An infant is brought to the emergency department with suspected coarctation of the aorta. Which clinical symptoms would the nurse expect to find?
Cyanosis of the lips and tongue
Weak or absent femoral pulses
Bounding pulses in the upper extremities
High blood pressure in the lower extremities
Poor feeding and irritability
Correct Answer : B,C,E
A. Cyanosis of the lips and tongue is not a typical finding in coarctation of the aorta; rather, it is more associated with cyanotic congenital heart defects.
B. Weak or absent femoral pulses are expected due to reduced blood flow to the lower body, as the coarctation typically occurs distal to the left subclavian artery.
C. Bounding pulses in the upper extremities are common because the blood flow to the upper body is increased, leading to stronger pulses.
D. High blood pressure in the lower extremities is not typical; instead, there is often lower blood pressure in the lower body due to the obstruction.
E. Poor feeding and irritability are common symptoms in infants with heart conditions, as they may be in distress or not getting enough blood flow to meet their metabolic needs.
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Correct Answer is C
Explanation
A. By age 6, while children can dress themselves, they may still need assistance with more complex grooming tasks, making this statement too absolute.
B. Counting backwards from 20 to 1 is typically expected by age 8, not age 7, indicating this statement is inaccurate regarding cognitive development.
C. Engaging in motor activities that require balance, such as jumping rope, is appropriate for children around age 6, demonstrating the expected physical development in this age group.
D. While children can use simple tools, mastery and effective use of tools like a screwdriver or hammer are more typical around ages 8 to 10, making this statement premature for age 6.
Correct Answer is D
Explanation
A. The ASO titer does not measure therapeutic levels of aminoglycosides; this response is incorrect.
B. The ASO titer is not a direct diagnostic test for rheumatic fever but indicates a recent infection with streptococcal bacteria, which can lead to rheumatic fever.
C. The test does not confirm immunity but rather measures antibodies against streptolysin O, indicating recent infection.
D. An elevated ASO titer confirms that the child had a recent streptococcal infection, which is important in diagnosing rheumatic fever.