Nokea
A 4-month-old infant with a ventricular septal defect (VSD) has dropped from the 20th percentile to the 5th for weight. What will the nurse practitioner recommend?
- A. Adding solid foods to the infant's diet to increase caloric intake
- B. Fortifying breast milk to increase the number of calories per ounce
- C. Stopping breastfeeding and giving 30 kcal/ounce formula
- D. Supplementing breastfeeding with 24 kcal/ounce formula
Correct Answer: B
Rationale: Infants with heart defects who have congestive heart failure (CHF) may need modification of formula or breast milk to increase calories. Fortifying breast milk is the first and best option.
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The most common cause of bacterial meningitis in children under 5 years is:
- A. Neisseria meningitidis
- B. Haemophilus influenzae
- C. Streptococcus pneumoniae
- D. Listeria monocytogenes
Correct Answer: C
Rationale: Streptococcus pneumoniae is the leading cause of bacterial meningitis in children under 5 years, especially in those who are not immunized.
The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?
- A. “I should avoid tub baths but may shower.â€
- B. “I have to stay on strict bed rest for 3 days.â€
- C. “I should remove the pressure dressing the day after the procedure.â€
- D. “I may attend school but should avoid exercise for several days.â€
Correct Answer: B
Rationale: The child does not need to be on strict bed rest for 3 days. Showers are recommended; children should avoid a tub bath. The pressure dressing is removed the day after the catheterization and replaced by an adhesive bandage to keep the area clean. Strenuous activity must be avoided for several days, but the child can return to school.
In Asia, the following hepatitis virus appears to be a significant cause of viral myocarditis
- A. hepatitis E virus
- B. hepatitis B virus
- C. hepatitis C virus
- D. hepatitis D virus
Correct Answer: A
Rationale: Hepatitis E virus has been identified as a significant cause of viral myocarditis in Asia.
Characteristic indices in anaemia of chronic inflammation:
- A. Increased MCV
- B. Decreased ferritin
- C. Decreased transferrin
- D. Normal MCHC
Correct Answer: C
Rationale: Decreased transferrin: In anaemia of chronic inflammation, transferrin levels decrease due to inflammatory cytokines, which affect iron metabolism and its availability for erythropoiesis.
Features of severe folate deficiency include:
- A. Steatorrhoea
- B. Glossitis
- C. Leucoerythroblastic picture
- D. Increased total iron binding capacity
Correct Answer: B
Rationale: Glossitis, or inflammation of the tongue, is a common feature of folate deficiency due to its role in cell division and growth.