Nokea
A child born with Trisomy 21 should be evaluated for which associated cardiac manifestation?
- A. Systemic hypertension
- B. Congenital heart defect
- C. Hyperlipidemia
- D. Cardiomyopathy
Correct Answer: B
Rationale: Children with Trisomy 21 (Down syndrome) have a high incidence of congenital heart defects, such as atrioventricular septal defects, and should be evaluated for these conditions.
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Recognised associations of Addison's disease include:
- A. Neurofibromatosis
- B. Phaeochromocytoma
- C. IDDM
- D. Nephrogenic diabetes insipidus
Correct Answer: C
Rationale: The correct answer is C because IDDM (insulin-dependent diabetes mellitus) is a recognized association of Addison's disease. The other options (a, b, d, e) are less commonly associated.
Maltese crosses' are identified in the urinary sediments in
- A. Niemann Pick disease
- B. Gaucher disease
- C. Krabbe's disease
- D. Fabry disease
Correct Answer: D
Rationale: Fabry disease is characterized by the presence of 'Maltese crosses' in urinary sediments due to glycosphingolipid accumulation.
A 5-year-old child who had a repair for transposition of the great arteries shortly after birth is growing normally and has been asymptomatic since the surgery. The primary care nurse practitioner notes mild shortness of breath with exertion and dizziness. What will the nurse practitioner do?
- A. Order an echocardiogram and chest radiograph.
- B. Perform pulmonary function testing.
- C. Reassure the parent that these symptoms are common.
- D. Refer the child to the cardiologist immediately.
Correct Answer: D
Rationale: Children with a history of transposition of the great arteries (d-TGA) who have a history of palpitations, syncope, or shortness of breath should be referred to a cardiologist.
Type I renal tubular acidosis:
- A. Only occurs in children
- B. Is caused by a failure of ammonium ion secretion
- C. Is associated with renal calcification
- D. Typically leads to hypovolaemia
Correct Answer: B
Rationale: Type I renal tubular acidosis is characterized by a failure in ammonium ion secretion, leading to a failure to acidify urine, which can result in metabolic acidosis.
Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?
- A. He is always hungry.
- B. He tires out during feedings.
- C. He is fussy for several hours every day.
- D. He sleeps all the time.
Correct Answer: B
Rationale: Fatigue during feeding or activity is common to most infants with congenital cardiac problems.