Choice A rationale:

Bluish discoloration of the skin, lips, or nail beds (cyanosis) is a classic symptom of cyanotic congenital heart disease (CCHD).

This occurs because of the inadequate oxygenation of the blood, which leads to oxygen-poor blood being circulated in the body.

Choice B rationale:

Poor feeding and inadequate weight gain can be associated with CCHD, especially when there is a significant reduction in cardiac output.

Infants with CCHD may have difficulty feeding due to the increased workload on their heart and may struggle to gain weight.

Choice C rationale:

Rapid breathing and shortness of breath are common symptoms in children with CCHD.

The inadequate oxygenation of the blood can lead to an increased respiratory rate and shortness of breath as the body tries to compensate for the lack of oxygen.

Choice D rationale:

Abnormal heart sounds heard during auscultation are characteristic of CCHD.

The specific type of abnormal heart sound may vary depending on the specific defect but can include murmurs, clicks, or other unusual sounds.

Choice E rationale:

Frequent respiratory infections are not typically associated with CCHD.

While children with CCHD may be more susceptible to infections due to their compromised oxygenation, it is not a direct symptom of the condition.