NR 602 COMPREHENSIVE ASSESSMENT
2026 COMPLETE QUESTIONS AND
ANSWERS
◉ Tetralogy of Fallot (TOF)
Answer: - 4 anatomic defects ( PV stenosis, RV hypertrophy, Aorta
overrides the ventricular septum, VSD
- Sx: cyanosis, dyspnea and cyanosis with feeding & crying poor wt
gain, grade 3-5 harsh systolic murmur L sternal border
- Tx:open heart surgery
◉ Mitral valve prolapse
Answer: - + family hx
- midsystolic click, thin, thoracic skeletal abnormalities
- inverted T waves in aVF
- normal CXR
◉ (coartication) of the aorta (COA)
Answer: - Narrowing of a small or long segment of the aorta
- Risk: male, other L heart abnormalities
- Sx: Severe: may be apparent in first 6 weeks. might have no sx until
3-5 yo. Upper extremity HTN, lower ext hypo., delayed timing or
,weak distal arterial pulses, bounding or bounding brachial radial &
carotid pulse, CHF signs, Systolic murmur, gallop
- Dx: Echo will confirm, MRI defines location & severity.
- Tx: PGE1 used in sev. neonates, surgery (restenosis likely if done
<1yo),
◉ Kawasaki Disease
Answer: - acute febrile illness
- risk: Asian/pacific islander, <6m >9 years, male, Poor outcomes=
asian, pacific, hispanic, person-person spread is low,
- Sx: 5 day fever, & bilat conjunctival infection, changes of the
lips/mouth, cervical lymphadenopathy, polymorphous exanthema or
changes in peripheral extremities or perineal area (swelling of
hands/feet).
- Alb <3, Urine >10 WBC, plet > 450,000 after 7 days of fever, anemia
consistent with age values, WBC > 15,000, & high alanine
aminotransferase.
- Triphasic: 1) acute: rash, hand/feet swelling, red eyes (spares
limbus), subacute: fever, rash & lymp swelling gone, arthralgia &
desquamation of skin over fingers, thrombocytosis & cardiac
disease. final (around day 25): myocarditis, elevated ESR, other signs
absent
- Tx: IVIG therapy, high dose ASA,
◉ Rheumatic Fever
, Answer: - autoimmune inflammatory process involving joints, heath,
CNS, and subq tissue. group A step
- Sx: Recent strep infection, chorea, erythema marginatum, subq
nodules, fever >38.5, prolonged PR, SR >30, Mitral regurg, Aortic
regurg, sx last 4 weeks w/o tx, carditis
- Tx: antibiotic for strep (penicillin or erythromycin), , NSAID's
◉ Asthma
Answer: - Step 1 (intermittent): sx <2x/week, normal PFts,
nighttime sx <2/month, exacerbations brief, no interference with
normal activity
- Step 2 (mild persistent): >2x/week but not more than 1 per day, 3-
4 nighttime sx/month, FEV >80%
- Step 3 (mod persistent): daily sx, daily SABA, some limitations,
exacerbations affect activity and may last days. FEV >60 but <80
- Step 4 (severe persistent): Continual sx, requires SABA several
x's/day, extremely limited physical activity, frequent exacerbations,
nightly sx, FEV <60%
◉ Asthma treatment steps
Answer: - Step 1: SABA PRn
- Step 2: Low-dose ICS, OR LTRA, Cromolyn
- Step 3: Low-dose ICS + LABA OR Med- dose ICS
- Step 4: Med- dose ICS + LABA OR med-dose ICS + LTRA
2026 COMPLETE QUESTIONS AND
ANSWERS
◉ Tetralogy of Fallot (TOF)
Answer: - 4 anatomic defects ( PV stenosis, RV hypertrophy, Aorta
overrides the ventricular septum, VSD
- Sx: cyanosis, dyspnea and cyanosis with feeding & crying poor wt
gain, grade 3-5 harsh systolic murmur L sternal border
- Tx:open heart surgery
◉ Mitral valve prolapse
Answer: - + family hx
- midsystolic click, thin, thoracic skeletal abnormalities
- inverted T waves in aVF
- normal CXR
◉ (coartication) of the aorta (COA)
Answer: - Narrowing of a small or long segment of the aorta
- Risk: male, other L heart abnormalities
- Sx: Severe: may be apparent in first 6 weeks. might have no sx until
3-5 yo. Upper extremity HTN, lower ext hypo., delayed timing or
,weak distal arterial pulses, bounding or bounding brachial radial &
carotid pulse, CHF signs, Systolic murmur, gallop
- Dx: Echo will confirm, MRI defines location & severity.
- Tx: PGE1 used in sev. neonates, surgery (restenosis likely if done
<1yo),
◉ Kawasaki Disease
Answer: - acute febrile illness
- risk: Asian/pacific islander, <6m >9 years, male, Poor outcomes=
asian, pacific, hispanic, person-person spread is low,
- Sx: 5 day fever, & bilat conjunctival infection, changes of the
lips/mouth, cervical lymphadenopathy, polymorphous exanthema or
changes in peripheral extremities or perineal area (swelling of
hands/feet).
- Alb <3, Urine >10 WBC, plet > 450,000 after 7 days of fever, anemia
consistent with age values, WBC > 15,000, & high alanine
aminotransferase.
- Triphasic: 1) acute: rash, hand/feet swelling, red eyes (spares
limbus), subacute: fever, rash & lymp swelling gone, arthralgia &
desquamation of skin over fingers, thrombocytosis & cardiac
disease. final (around day 25): myocarditis, elevated ESR, other signs
absent
- Tx: IVIG therapy, high dose ASA,
◉ Rheumatic Fever
, Answer: - autoimmune inflammatory process involving joints, heath,
CNS, and subq tissue. group A step
- Sx: Recent strep infection, chorea, erythema marginatum, subq
nodules, fever >38.5, prolonged PR, SR >30, Mitral regurg, Aortic
regurg, sx last 4 weeks w/o tx, carditis
- Tx: antibiotic for strep (penicillin or erythromycin), , NSAID's
◉ Asthma
Answer: - Step 1 (intermittent): sx <2x/week, normal PFts,
nighttime sx <2/month, exacerbations brief, no interference with
normal activity
- Step 2 (mild persistent): >2x/week but not more than 1 per day, 3-
4 nighttime sx/month, FEV >80%
- Step 3 (mod persistent): daily sx, daily SABA, some limitations,
exacerbations affect activity and may last days. FEV >60 but <80
- Step 4 (severe persistent): Continual sx, requires SABA several
x's/day, extremely limited physical activity, frequent exacerbations,
nightly sx, FEV <60%
◉ Asthma treatment steps
Answer: - Step 1: SABA PRn
- Step 2: Low-dose ICS, OR LTRA, Cromolyn
- Step 3: Low-dose ICS + LABA OR Med- dose ICS
- Step 4: Med- dose ICS + LABA OR med-dose ICS + LTRA
