Nokea
A 15-year-old female reports fainting at school in class on two occasions. The adolescent's orthostatic blood pressures are normal. The primary care pediatric nurse practitioner suspects a cardiac cause for these episodes and will order which tests before referring her to a pediatric cardiologist?
- A. 12-lead electrocardiogram
- B. Echocardiogram
- C. Tilt table testing
- D. Treadmill exercise testing
Correct Answer: A
Rationale: A 12-lead ECG is useful for initial evaluation.
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Histochemical staining used for diagnosing Hirschsprung's disease is
- A. Acetyl choline esterase
- B. Dopamine
- C. Glutamate
- D. Chromogranin and synaptophysin
Correct Answer: A
Rationale: Acetylcholine esterase staining is used to diagnose Hirschsprung's disease by identifying the absence of ganglion cells.
Systolic murmur in which among the following conditions does not increase in intensity in the cardiac cycle after a premature ventricular contraction?
- A. Valvular aortic stenosis
- B. Hypertrophic obstructive cardiomyopathy
- C. Valvular pulmonic stenosis
- D. Mitral valve prolapse
Correct Answer: D
Rationale: Mitral valve prolapse does not typically increase in intensity after a premature ventricular contraction.
The most likely diagnosis in the patient described is
- A. persistent pulmonary hypertension
- B. transposition of the great arteries
- C. truncus arteriosus
- D. pulmonary atresia
Correct Answer: B
Rationale: Transposition of the great arteries often presents with cyanosis due to mixing of oxygenated and deoxygenated blood.
What should the school nurse recommend when encouraging a heart-healthy diet for a child with high cholesterol?
- A. A fat intake reduction of 5-10% of total calories
- B. A fat intake reduction of 10-15% of total calories
- C. A fat intake reduction of 15-20% of total calories
- D. A fat intake reduction of 25-35% of total calories
Correct Answer: D
Rationale: For a child with increased cholesterol, a fat reduction of 25-35% of total calories with less than 75 saturated fat and less than 200 mg of cholesterol per day is advised.
Renal damage is a recognised complication of infection with:
- A. Plasmodium Jalciparum
- B. Schistosoma haematobium
- C. Plasmodium malariae
- D. Leptospira icterohaemorrhagica
Correct Answer: D
Rationale: Leptospira icterohaemorrhagica can cause renal damage. Plasmodium species and Schistosoma are less commonly associated with renal complications.