Nokea
During a well baby examination of a 6-week-old infant, poor weight gain, acrocyanosis of the hands and feet, and a respiratory rate of 60 breaths per minute are noted. Oxygen saturation on room air is 93%. What is the correct action?
- A. Follow-up in 1 week to assess the infant's weight.
- B. Order a chest radiograph and an electrocardiogram.
- C. Reassure the parents that the exam is within normal limits.
- D. Refer the infant to a pediatric cardiologist.
Correct Answer: D
Rationale: Infants with oxygen saturation less than 95% and those with poor feeding should be referred emergently to a cardiologist.
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List FOUR differential diagnoses aside from aortic coarctation for a two-week old infant presenting with tachypnea and poor femoral pulses.
- A. Tachycardia induced cardiomyopathy
- B. Critical aortic stenosis
- C. Dilated cardiomyopathy
- D. Myocarditis
Correct Answer: A
Rationale: Differential diagnoses in such cases can include non-structural heart conditions like tachycardia induced cardiomyopathy, which affects the heart's ability to pump effectively.
The following are transmitted as autosomal dominant traits:
- A. Congenital spherocytosis
- B. Vitamin D-resistant rickets
- C. CAH
- D. Hereditary haemorrhagic telangiectasia
Correct Answer: D
Rationale: Hereditary haemorrhagic telangiectasia is an autosomal dominant disorder. Congenital spherocytosis and Vitamin D-resistant rickets can also be autosomal dominant, but CAH (Congenital Adrenal Hyperplasia) is typically autosomal recessive.
Mitral valve prolapse
- A. Occurs in congenital myxomatous valves
- B. Need a Sx
- C. Rare cause of MR
- D. Need prophylactic antibiotics
Correct Answer: A
Rationale: Mitral valve prolapse often occurs in congenital myxomatous valves.
A nurse is caring for a client with Diabetes Insipidus (DI). Which data warrants the most immediate intervention by the nurse?
- A. Serum sodium of 185 mEq/L
- B. Urine output of 3000 mL per hour.
- C. Blood pressure of 90/60 mmHg.
- D. Potassium level of 4.5 mEq/L.
Correct Answer: A
Rationale: A serum sodium level of 185 mEq/L indicates severe hypernatremia, which is life-threatening and requires immediate intervention.
For one of the following, total repair is really achieved, with no requirement for long-term follow-up
- A. atrial septal defects
- B. ventricular septal defects
- C. pulmonic stenosis
- D. uncomplicated isolated pulmonic stenosis
Correct Answer: D
Rationale: Uncomplicated isolated pulmonic stenosis can often be repaired with no need for long-term follow-up.