Nokea
Increased TSH is seen in a neonate with:
- A. Thyroxine insensitivity
- B. Iodine deficiency
- C. Hyperbilirubinaemia
- D. Thyroid agenesis
Correct Answer: B
Rationale: Iodine deficiency: Neonates with iodine deficiency often present with increased TSH levels as the body attempts to compensate for low thyroid hormone production.
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The nurse is caring for a school-age child who has had a cardiac catheterization. The child tells the nurse that the bandage is “too wet.†The nurse finds the bandage and bed soaked with blood. What is the priority nursing action?
- A. Notify physician
- B. Apply new bandage with more pressure
- C. Place the child in Trendelenburg position
- D. Apply direct pressure above catheterization site
Correct Answer: D
Rationale: If bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the percutaneous skin site to localize pressure over the vessel puncture. Notifying a physician and applying a new bandage can be done after pressure is applied. The nurse can have someone else notify the physician while the pressure is being maintained. It is not a helpful intervention to place the girl in the Trendelenburg position. It would increase the drainage from the lower extremities.
The following are examples of acquired heart disease. Select all that apply.
- A. Infective endocarditis
- B. Coarctation of the aorta
- C. Rheumatic fever (RF)
- D. Cardiomyopathy
Correct Answer: C
Rationale: Acquired heart diseases include conditions that develop after birth, such as infective endocarditis, rheumatic fever, cardiomyopathy, and Kawasaki disease. Coarctation of the aorta and transposition of the great vessels are congenital heart defects.
Which of the following features favor a diagnosis of restrictive cardiomyopathy over constrictive pericarditis?
- A. Elevated pulmonary artery pressures
- B. Normal BNP levels
- C. Annulus reversus
- D. Ventricular interdependence
Correct Answer: A
Rationale: Restrictive cardiomyopathy is associated with elevated pulmonary artery pressures
Regarding cafe-au-lait spots:
- A. They can be normal findings
- B. They are found in tuberous sclerosis
- C. When present in a child, > 4 spots each > 0.5 cm, is diagnostic of neurofibromatosis type II
- D. Typical appearance in neurofibromatosis is of a smooth border
Correct Answer: A
Rationale: Cafe-au-lait spots can be a normal variant and do not always indicate an underlying pathology.
Which drug should not be used to control secondary hypertension in a sexually active adolescent female who uses intermittent birth control?
- A. Beta blockers
- B. Calcium channel blockers
- C. ACE inhibitors
- D. Diuretics
Correct Answer: C
Rationale: ACE inhibitors and angiotensin II receptor blockers are teratogenic and should be avoided in sexually active adolescents using birth control.