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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Which finding would alert a nurse that a hospitalized 6-year-old child is at risk for a severe asthma exacerbation?
- A. Oxygen saturation of 95%
- B. Mild work of breathing
- C. Absence of intercostals or substernal retractions
- D. History of steroid-dependent asthma
Correct Answer: D
Rationale: A history of steroid-dependent asthma indicates severe asthma, increasing the risk of a life-threatening exacerbation.
Regarding diphtheria correct statement is
- A. Falling levels of immunity in the adult population is a reason for sporadic cases in the immunization era
- B. Immunization abolishes carrier state
- C. Antibiotic prophylaxis is not indicated for asymptomatic case contacts who are not carriers (negative cultures)
- D. Asymptomatic case contacts who are carriers should be administered antibiotic prophylaxis and antitoxin
Correct Answer: A
Rationale: Falling immunity levels in adults contribute to sporadic cases of diphtheria even in the immunization era.
Nurse Oliver s teaching a mother who plans to discontinue breast-feeding after 5 months. The nurse should advise her to include which foods in her infant’s diet?
- A. Iron-rich formula and baby food
- B. Whole milk and baby food
- C. Skim milk and baby food
- D. Iron-rich formula only
Correct Answer: A
Rationale: Iron-rich formula and baby food provide essential nutrients for a 5-month-old infant transitioning from breastfeeding.
Elevated levels of CPK are seen in:
- A. Duchenne muscular dystrophy
- B. Dermatomyositis
- C. Spinal muscular atrophy
- D. Malignant hyperthermia
Correct Answer: A
Rationale: Duchenne muscular dystrophy: Elevated creatine phosphokinase (CPK) levels are a hallmark of Duchenne muscular dystrophy due to muscle damage and degeneration.
All are true about TAPSE (Tricuspid Annular Plane Systolic Excursion), except
- A. Normal TAPSE is >17 mm
- B. Reliable measure of RV systolic function
- C. Can be measured using either M-mode or 2D echo
- D. TAPSE is measured at septal aspect of tricuspid annulus
Correct Answer: D
Rationale: TAPSE is measured at the lateral aspect of the tricuspid annulus, not the septal aspect.