Nokea
A 2-year-old child should be able to:
- A. Name three colours correctly
- B. Use plurals
- C. Build a tower of five blocks
- D. Kick a ball on request
Correct Answer: C
Rationale: A 2-year-old can typically build a tower of five blocks. Naming colors and using plurals are more advanced skills, and kicking a ball is variable.
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The enzyme producing carbon monoxide within the human body is
- A. Aminolevulinic acid synthase
- B. Heme oxygenase
- C. Cyclo-oxygense
- D. Nitric oxide synthase
Correct Answer: B
Rationale: Heme oxygenase is responsible for the production of carbon monoxide during the breakdown of heme.
The child becomes unresponsive. The most likely underlying lesion is
- A. cardiomyopathy
- B. anomalous coronary artery
- C. tetralogy of Fallot
- D. constipation
Correct Answer: C
Rationale: Tetralogy of Fallot can cause hypoxic spells leading to unresponsiveness.
Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)?
- A. Chickenpox or influenza
- B. E. coli or staphylococcus
- C. Mumps or streptococcus A
- D. Streptococcus A or staphylococcus
Correct Answer: A
Rationale: Both chickenpox and influenza are viral; during these illnesses, aspirin (a salicylate) is typically discontinued due to the risk of Reye syndrome.
The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct?
- A. “You may need to increase the caloric density of your infant’s formula.â€
- B. “You should feed your baby every 2 hours.â€
- C. “You may need to increase the amount of formula your infant eats with each feeding.â€
- D. “You should place a nasal oxygen cannula on your infant during and after each feeding.â€
Correct Answer: A
Rationale: The metabolic rate of infants with heart failure is greater because of poor cardiac function and increased heart and respiratory rates. Their caloric needs are greater than those of the average infants, yet their ability to take in the calories is diminished by their fatigue. Infants with heart failure should be fed every 3 hours; a 2-hour schedule does not allow for enough rest, and a 4-hour schedule is too long. Fluids must be carefully monitored because of the heart failure. Infants do not require supplemental oxygen with feedings.
What are FOUR possible causes of left axis deviation in a newborn with features of Trisomy 21?
- A. AVSD
- B. Tricuspid atresia
- C. Pulmonary atresia with intact ventricular septum
- D. Mechanical shift
Correct Answer: A
Rationale: AVSD is a common congenital heart defect associated with Trisomy 21 and can lead to left axis deviation seen on ECG.