Nokea
Correct statement regarding congenital rubella syndrome (CRS) is
- A. CRS with vaccine-strain of virus has not been reported
- B. Re-infections during pregnancy do not result in CRS
- C. Administration of immune globulin immediately after exposure to a case during pregnancy is effective in preventing CRS
- D. Patent ductus arteriosus is the commonest manifestation of CRS
Correct Answer: A
Rationale: CRS with the vaccine-strain of the virus has not been reported, as the vaccine strain is attenuated and does not cause congenital infection.
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The following statements are true:
- A. Unexplained vaginal discharge in a 3-year-old might be a sign of sexual abuse
- B. Spiral fracture of femur is always non-accidental
- C. Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome
- D. Bruises on the elbows and knees in a 4-year-old are suggestive of physical abuse
Correct Answer: C
Rationale: Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome: Retinal bleeding in infants, especially with other signs of physical abuse, is a key indicator of 'shaken baby' syndrome.
A harsh, blowing grade IV/VI murmur is auscultated in a 6-month-old infant. What will the nurse practitioner do next?
- A. Get a complete blood count to rule out severe anemia.
- B. Obtain an electrocardiogram to assess for arrhythmia.
- C. Order a chest radiograph to evaluate for cardiomegaly.
- D. Refer to a pediatric cardiologist for further evaluation.
Correct Answer: D
Rationale: A harsh, blowing murmur is suspicious for pathology, so a cardiology referral is warranted.
In which of the following valve lesions, Dimensionless Index (DI) is used as an echocardiographic parameter to assess the severity of the lesion?
- A. Aortic stenosis
- B. Aortic regurgitation
- C. Mitral regurgitation
- D. Mitral stenosis
Correct Answer: A
Rationale: Dimensionless Index (DI) is used to assess the severity of aortic stenosis.
A 70-year-old male client with type 2 diabetes mellitus (DM) is hospitalized with an infected ulcer on his great right toe. Which instruction should the nurse emphasize during discharge teaching?
- A. Check the insides and linings of all enclosed shoes before putting the shoes on
- B. Wash the feet with soap and water, then apply a topical antibiotic ointment.
- C. Trim toenails weekly to prevent injury.
- D. Avoid wearing sandals or open-toed shoes.
Correct Answer: A
Rationale: Preventing trauma to the feet is critical for clients with diabetes to avoid complications like infections and ulcers.
All patients with clinical evidence of a PDA are at increased risk for endocarditis. As a result, patients with PDA should be considered for irreversible closure EXCEPT
- A. small, hemodynamically insignificant PDA
- B. small, hemodynamically significant PDA
- C. moderate PDA
- D. large PDA
Correct Answer: A
Rationale: Small, hemodynamically insignificant PDAs may not require closure.