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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A client returns to the unit following a suprapubic prostatectomy. He has a three-way catheter in place with a continuous bladder irrigation infusing. Which assessment finding warrants immediate intervention by the nurse?
- A. True urinary output of 50ml/hr
- B. Lower abdominal tenderness
- C. Blood urine output with clots
- D. Urine leaking around the meatus
Correct Answer: D
Rationale: Urine leaking around the meatus may indicate catheter displacement or obstruction, requiring immediate attention to prevent complications.
What is one reason why patients with CHD are more likely to have rejection post-transplant than those with cardiomyopathy?
- A. Sensitized recipients with panel reactive antibody (PRA)
- B. Absence of systemic disease
- C. History of good compliance
- D. None of the above
Correct Answer: A
Rationale: Patients with congenital heart disease (CHD) are often sensitized due to prior surgeries and blood transfusions, leading to a higher risk of rejection post-transplant.
An infant aged 16 months was referred for assessment of suspected mental retardation. Which of the following findings is/are outside the normal range?
- A. He does not scribble spontaneously with pencil on paper
- B. He does not walk alone
- C. Ma' and 'Dada' are the only recognisable words
- D. He is unable to build a tower of four cubes
Correct Answer: B
Rationale: Not walking alone by 16 months is a concern. Scribbling, limited vocabulary, and building towers are less concerning at this age.
Which of the following statements is incorrect regarding shock?
- A. In cardiogenic shock systemic vascular resistance is high
- B. In hypovolemic shock pulmonary capillary wedge pressure is reduced
- C. In distributive shock central venous pressure is increased
- D. In hypovolemic shock mean arterial pressure is normal
Correct Answer: D
Rationale: In hypovolemic shock
Recognised features of myotonic dystrophy include:
- A. Phenomenon of anticipation
- B. Muscle pain
- C. Diplopia
- D. Cardiomyopathy
Correct Answer: A
Rationale: The phenomenon of anticipation, where symptoms become more severe or appear at an earlier age as the disorder is passed through generations, is a recognized feature of myotonic dystrophy.