Nokea
Diagnosis of nocturnal enuresis can be made in:
- A. A 3-year-old boy with recurrent bedwetting
- B. A 4-year-old who has started bedwetting after attaining complete toilet control at 3½ years of age
- C. A 5-year-old girl who is recently staining her underclothes at school
- D. A 6-year-old recovering from a recent UTI
Correct Answer: B
Rationale: A 4-year-old who has started bedwetting after attaining complete toilet control at 3½ years of age: Nocturnal enuresis is diagnosed if bedwetting persists beyond the age of 5, especially if it starts after toilet training.
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The primary care pediatric nurse practitioner is performing a sports physical on an adolescent whose history reveals mild aortic stenosis (AS). What will the nurse practitioner recommend?
- A. Avoidance of all sports to prevent sudden death
- B. Clearance for any sports since this is mild
- C. Evaluation by a cardiologist prior to participation
- D. Low-intensity sports
Correct Answer: C
Rationale: Children with mild AS may participate in any sport but must have annual cardiac evaluations.
Commonly used anti-epileptic drugs in children include:
- A. Sodium valproate
- B. Lamotrigine
- C. Topiramate
- D. Phenytoin
Correct Answer: A
Rationale: The correct answer is A because sodium valproate is a commonly used anti-epileptic drug in children. The other options (b-e) are also used but are not the most common first-line treatment.
The following statements about immunoglobulins are false:
- A. IgG is not transferable across the placenta
- B. IgM is usually a pentamer
- C. IgE levels are raised in parasitic infestations
- D. IgD is important in antibody dependent cytotoxicity
Correct Answer: A
Rationale: IgG is not transferable across the placenta: IgG is the only immunoglobulin that crosses the placenta to provide passive immunity to the fetus.
What are TWO possible interventions for an infant with Tetralogy of Fallot who has recurrent desaturation episodes on propranolol?
- A. Full surgical repair
- B. Interim repair with RVOT stent or shunt
- C. Propranolol dose adjustment
- D. All of the above
Correct Answer: B
Rationale: Interim repair with RVOT stent or shunt can be used to improve oxygenation in infants who are not candidates for immediate full surgical repair.
While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has:
- A. Pulmonary hypertension
- B. Patent ductus arteriosus (PDA)
- C. Ventricular septal defect (VSD)
- D. Bronchopulmonary dysplasia
Correct Answer: B
Rationale: A machine-like murmur is the hallmark of a PDA.