Nokea
An infant with trisomy 21 has a complete AV canal defect. Which finding associated with both conditions will the primary care pediatric nurse practitioner expect?
- A. Crackles in both lungs
- B. Hepatomegaly
- C. Oxygen desaturation
- D. Peripheral edema
Correct Answer: C
Rationale: Because infants with trisomy 21 maintain neonatal high pulmonary vascular resistance, they often do not show signs of CHF but instead will have signs of pulmonary hypertension with loud single S2 and desaturation with agitation or effort.
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Usual indications for an exchange transfusion in a child with sickle cell disease include:
- A. Painful vaso-occlusive crisis
- B. Splenic sequestration crisis
- C. Acute chest syndrome
- D. Dactylitis
Correct Answer: C
Rationale: Acute chest syndrome, a severe complication of sickle cell disease, often requires exchange transfusion to reduce the proportion of sickle hemoglobin and improve oxygenation.
All of the following are conditions with combined cellular and antibody immunodeficiency, except
- A. Ataxia telangiectasia
- B. Reticular dysgenesis
- C. Common variable immunodeficiency
- D. Severe combined immunodeficiency
Correct Answer: C
Rationale: Common variable immunodeficiency (CVID) is primarily an antibody deficiency, not a combined immunodeficiency.
Regarding iron deficiency anemia, which of the following is true?
- A. Ferritin levels are elevated
- B. Red blood cell count is usually normal
- C. Hemoglobin is usually decreased
- D. Serum iron levels are elevated
Correct Answer: C
Rationale: In iron deficiency anemia, hemoglobin levels are usually decreased due to insufficient iron for red blood cell production.
A nurse cares for a client who has advanced cardiac disease and states, I am having trouble sleeping at night. How should the nurse respond?
- A. I will consult the provider to prescribe a sleep study to determine the problem.
- B. You become hypoxic while sleeping; oxygen therapy via nasal cannula will help.
- C. A continuous positive airway pressure, or CPAP, breathing mask will help you breathe at night.
- D. Use pillows to elevate your head and chest while you are sleeping.
Correct Answer: D
Rationale: Elevating the head and chest can reduce fluid accumulation in the lungs, improving breathing and sleep quality in clients with advanced cardiac disease.
The following drugs induce hepatic enzymes:
- A. Rifampicin
- B. Phenobarbitone
- C. Cimetidine
- D. Erythromycin
Correct Answer: A
Rationale: Rifampicin is known to induce hepatic enzymes, which can increase the metabolism of other drugs and reduce their efficacy.