Nokea
A diagnosis of primary pulmonary hypertension of the newborn can be made if:
- A. Oxygen saturation in the hand is 80% and in the foot 67%
- B. A tachypnoeic baby has a saturation of 60%
- C. A baby with history of being covered in thick meconium at birth has PaO2 of 4kPa
- D. A septic baby is hypoxic in 100% oxygen
Correct Answer: A
Rationale: A significant difference in oxygen saturation between the upper and lower extremities (e.g., hand 80%, foot 67%) is indicative of persistent pulmonary hypertension of the newborn (PPHN).
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The mother of a toddler reports that the child's father has just had a myocardial infarction (MI). Because of this, the nurse recommends the child have a(n):
- A. Electrocardiogram
- B. Lipid profile
- C. Echocardiogram
- D. Cardiac catheterization
Correct Answer: B
Rationale: Current recommendations are for a lipid profile in children over 2 years of age who have a family history of cardiac events or high cholesterol.
Which client has the highest risk for developing skin cancer?
- A. A 16-year old dark-skinned female who tans in tanning beds once a week
- B. A 65 year-old fair-skinned male who is a construction worker
- C. A 25 year-old dark-skinned male whose mother had skin cancer
- D. A 70 year-old fair-skinned female who works as a secretary
Correct Answer: B
Rationale: Fair-skinned individuals with prolonged sun exposure, such as construction workers, are at higher risk for skin cancer.
In neonates with anomalous total pulmonary venous return and obstruction, the chest x-ray demonstrates
- A. heart enlarged
- B. prominent pulmonary artery
- C. prominent right ventricle
- D. prominent subaortic stenosis
Correct Answer: D
Rationale: Prominent subaortic stenosis is not typically seen in TAPVR.
One of the following is a sign of right-sided heart failure of the patient
- A. tachypnea
- B. orthopnea
- C. wheezing
- D. pulmonary edema
Correct Answer: B
Rationale: Right-sided heart failure typically presents with systemic signs like orthopnea and peripheral edema rather than pulmonary edema.
The reason that the hematocrit is so high is
- A. chronic hypoxia
- B. it was taken in a low cardiac output state
- C. it was a peripheral finger stick
- D. embolic stroke
Correct Answer: A
Rationale: Chronic hypoxia leads to secondary polycythemia as a compensatory mechanism.