Nokea
Features differentiating renal tubular acidosis type II from type I include:
- A. Increased anion gap
- B. Nephrocalcinosis
- C. Urinary pH can be lowered < 5.5 in ammonium chloride loading test in type I
- D. Aminoaciduria
Correct Answer: C
Rationale: In type I renal tubular acidosis, urinary pH can be lowered below 5.5 during an ammonium chloride loading test, unlike in type II.
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Which of the following skills would be expected of a 7-month-old infant but not of a 5-month-old infant?
- A. Crawls
- B. Smiles socially
- C. Controls bowel and bladder
- D. Sits unsupported
Correct Answer: D
Rationale: A 7-month-old can typically sit unsupported, while a 5-month-old cannot. Crawling and social smiling develop earlier, and bowel control is not expected at this age.
An infant with trisomy 21 has a complete AV canal defect. Which finding associated with both conditions will the primary care pediatric nurse practitioner expect?
- A. Crackles in both lungs
- B. Hepatomegaly
- C. Oxygen desaturation
- D. Peripheral edema
Correct Answer: C
Rationale: Because infants with trisomy 21 maintain neonatal high pulmonary vascular resistance, they often do not show signs of CHF but instead will have signs of pulmonary hypertension with loud single S2 and desaturation with agitation or effort.
Factors triggering renin stimulation:
- A. Hyponatraemia
- B. ACTH
- C. Hypovolaemia
- D. ANP
Correct Answer: C
Rationale: Hypovolaemia
Which among the following is not a feature of low flow - low gradient severe aortic stenosis with preserved left ventricular function?
- A. Mean trans aortic pressure gradient < 40 mm Hg
- B. Aortic valve area < 1 cm²
- C. Stroke volume > 35 ml/m²
- D. Left ventricular ejection fraction > 50%
Correct Answer: C
Rationale: Stroke volume is typically reduced, not increased, in low flow - low gradient severe aortic stenosis.
Severe hypothermia in newborn is defined as temperature below
- A. 28° C
- B. 30° C
- C. 32° C
- D. 34° C
Correct Answer: A
Rationale: Severe hypothermia in newborns is defined as a core body temperature below 28° C, which is life-threatening and requires immediate intervention.