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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Nurse Mariane is caring for an infant with spina bifida. Which technique is most important in recognizing possible hydrocephalus?
- A. Measuring head circumference
- B. Obtaining skull X-ray
- C. Performing a lumbar puncture
- D. Magnetic resonance imaging (MRI)
Correct Answer: A
Rationale: Measuring head circumference is a non-invasive way to monitor for hydrocephalus, a common complication of spina bifida.
Isovolumic contraction phase of ventricular systole occurs during which of the following phases of central venous pressure, approximately
- A. From nadir of y descent to peak of a wave
- B. From peak of a wave to trough of x wave
- C. From trough of x wave to peak of c wave
- D. From peak of c wave to trough of x' descent
Correct Answer: C
Rationale: Isovolumic contraction occurs from the trough of the x wave to the peak of the c wave.
A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates?
- A. Seizure activity
- B. Hypoxia
- C. Sydenham’s chorea
- D. Decreasing level of consciousness
Correct Answer: C
Rationale: As the effects of rheumatic fever affect the central nervous system, the child may develop Sydenham’s chorea, manifested by involuntary, purposeless movements of the limbs.
Insulin-like growth factor-l (IGF-I):
- A. Increases during pubertal growth spurt
- B. Is a single polypeptide chain
- C. Is produced in pancreas
- D. Is secreted in a pulsatile manner
Correct Answer: A
Rationale: IGF-I levels rise significantly during the pubertal growth spurt, contributing to rapid growth and development.
A nurse is preparing to administer an angiotensin-converting enzyme (ACE) inhibitor. Which drug should the nurse administer?
- A. Captopril (Capoten)
- B. Furosemide (Lasix)
- C. Spironolactone (Aldactone)
- D. Chlorothiazide (Diuril)
Correct Answer: A
Rationale: Captopril is an ACE inhibitor. Furosemide is a loop diuretic. Spironolactone blocks the action of aldosterone. Chlorothiazide works on the distal tubules.