Nokea
Common presenting features of myotonic dystrophy are:
- A. Floppy infant
- B. Corneal opacities
- C. Frontal baldness
- D. Macro-orchidism
Correct Answer: D
Rationale: Macro-orchidism: Myotonic dystrophy is characterized by muscle weakness and myotonia. Macro-orchidism (enlarged testes) is a distinctive feature, especially in male patients.
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Absent jugular venous pulsations are described in patients with
- A. Atrial paralysis
- B. Budd Chiari syndrome
- C. Endomyocardial fibrosis with giant right atrium
- D. Fontan procedure
Correct Answer: D
Rationale: Absent jugular venous pulsations are described in patients with the Fontan procedure due to the absence of a right atrial pump.
What are FIVE possible etiologies for a heart rate of 40 bpm with atrial rate of 92 bpm and AV-dissociation in a 4-year-old girl?
- A. Congenital CHB from maternal Lupus
- B. Fetal myocarditis
- C. CCTGA
- D. Medication induced
Correct Answer: A
Rationale: Congenital heart block from maternal conditions like lupus can present with low heart rate and AV dissociation in a young child.
Methaemoglobinaemia may occur as a result of ingestion or exposure to:
- A. Paraquat
- B. Methylene blue
- C. Potassium permanganate
- D. Nitrates
Correct Answer: D
Rationale: Nitrates, when ingested, can lead to methaemoglobinaemia by converting hemoglobin to methemoglobin, impairing oxygen delivery.
A 5-year-old child has an elevated blood pressure during a well child exam. The primary care pediatric nurse practitioner notes mottling and pallor of the child's feet and lower legs and auscultates a systolic ejection murmur in the left infraclavicular region radiating to the child's back. The nurse practitioner will suspect which condition?
- A. Aortic stenosis (AS)
- B. Coarctation of the aorta (COA)
- C. Patent ductus arteriosus (PDA)
- D. Pulmonic stenosis
Correct Answer: B
Rationale: Coarctation of the aorta may not have symptoms until later childhood and may present as high blood pressure in the upper extremities and poor perfusion in the lower extremities.
Patrick, a healthy adolescent has meningitis and is receiving I.V. and oral fluids. The nurse should monitor this client’s fluid intake because fluid overload may cause:
- A. Cerebral edema
- B. Dehydration
- C. Heart failure
- D. Hypovolemic shock
Correct Answer: A
Rationale: Fluid overload in a patient with meningitis can exacerbate cerebral edema, increasing intracranial pressure and worsening the condition.