Nokea
During a routine well child exam on a 5-year-old child, a grade II/VI, harsh, late systolic ejection murmur at the upper left sternal border that transmits to both lung fields is auscultated. The child has normal growth and development. What will the nurse practitioner suspect?
- A. Aortic stenosis (AS)
- B. Patent ductus arteriosus (PDA)
- C. Pulmonic stenosis
- D. Tricuspid atresia
Correct Answer: C
Rationale: Pulmonic stenosis may be asymptomatic with a murmur as described above.
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Which high level labs should the nurse explain can prevent cardiovascular disease?
- A. Cholesterol
- B. Triglycerides
- C. Low-density lipoproteins (LDLs)
- D. High-density lipoproteins (HDLs)
Correct Answer: D
Rationale: HDLs contain very low concentrations of triglycerides, relatively little cholesterol, and high levels of proteins. It is thought that HDLs protect against cardiovascular disease. Cholesterol, triglycerides, and LDLs are not protective against cardiovascular disease.
How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G?
- A. 1 year
- B. 2 years
- C. 5 years
- D. 10 years
Correct Answer: C
Rationale: Children who recover from rheumatic fever should have a chemoprophylaxis protocol of penicillin G injections (about 200,000 units per dose) for a minimum of 5 years or up to the age of 18 to prevent further bouts of rheumatic fever.
A parent brings a toddler, age 19 months, to the clinic for a regular check-up. When palpating the toddler’s fontanels, what should the nurse expects to find?
- A. Closed anterior fontanel and open posterior fontanel
- B. Open anterior and fontanel and closed posterior fontanel
- C. Closed anterior and posterior fontanels
- D. Open anterior and posterior fontanels
Correct Answer: C
Rationale: By 19 months, both the anterior and posterior fontanels should be closed as the skull bones have fused.
Recognized features in Ehlers-Danlos syndrome include:
- A. Mutation in fibrillin gene
- B. Short stature
- C. Keratoconus
- D. Easy scarring
Correct Answer: D
Rationale: Easy scarring: Ehlers-Danlos syndrome is a connective tissue disorder characterized by hyperelastic skin, joint hypermobility, and easy bruising and scarring.
Congenital complete heart block
- A. Corrected TGA
- B. SLE mother's child
- C. Plonged QT
- D. MgSO4 therapy to mother
Correct Answer: B
Rationale: Congenital complete heart block is often associated with mothers who have systemic lupus erythematosus.