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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The following are true of umbilical hernia:
- A. It is more common in Caucasian than Blacks
- B. It is commonly associated with hypothyroidism
- C. It must be operated on by two years of age
- D. It becomes obstructed in 2% of cases
Correct Answer: D
Rationale: Umbilical hernias can become obstructed in about 2% of cases. They are more common in Blacks and are not typically associated with hypothyroidism.
Childhood schizophrenia is suggested by:
- A. Disturbance in movement patterns
- B. Persistent thumb sucking
- C. Hallucinations
- D. Infantile autism
Correct Answer: C
Rationale: Hallucinations are a key feature of childhood schizophrenia. Movement disturbances and thumb sucking are nonspecific, and infantile autism is a separate condition.
Which among the following is not an admixture lesion?
- A. Transposition of great arteries
- B. Truncus arteriosus
- C. Total anomalous pulmonary venous connection
- D. Pulmonary atresia with intact ventricular septum
Correct Answer: D
Rationale: Pulmonary atresia with intact ventricular septum is not an admixture lesion.
The most likely diagnosis in the patient is
- A. patent ductus arteriosus
- B. critical aortic stenosis
- C. critical pulmonic stenosis
- D. tetralogy of Fallot
Correct Answer: D
Rationale: Tetralogy of Fallot involves right ventricular hypertrophy, a VSD, overriding aorta, and pulmonary stenosis, consistent with the findings.
On assessment of a child admitted with a diagnosis of Kawasaki Disease, the nurse expects to note which clinical manifestation of the acute phase of the disease?
- A. Cracked lips
- B. Normal appearance
- C. Conjuntival hyperemia
- D. Desquamation of the skin
Correct Answer: C
Rationale: Conjunctival hyperemia is a common clinical manifestation during the acute phase of Kawasaki Disease, characterized by redness of the eyes without discharge.