Nokea
Initial tests in a 2-year-old child with failure to thrive include:
- A. Thyroid function tests
- B. Sweat test
- C. Urine culture
- D. Colonoscopy
Correct Answer: B
Rationale: a sweat test is crucial for diagnosing cystic fibrosis, a common cause of failure to thrive in children. The other tests (a-d) are less specific and not typically first-line for this presentation.
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The following are causes of congestive heart failure and cardiomegaly during the newborn period but no murmur EXCEPT
- A. endocardial fibroelastosis
- B. asphyxia
- C. glycogen storage disease (Pompe disease)
- D. sepsis
Correct Answer: D
Rationale: Sepsis can cause heart failure and cardiomegaly but often presents with other systemic signs.
Prior to the patient being given medication, he becomes hypotensive, mottled, and cold. His heart rate is 240. The next therapeutic step should be
- A. digoxin
- B. synchronized DC cardioversion
- C. lidocaine
- D. defibrillation
Correct Answer: B
Rationale: Synchronized DC cardioversion is indicated for unstable tachycardia unresponsive to pharmacological agents.
Systolic murmur in which among the following conditions does not increase in intensity in the cardiac cycle after a premature ventricular contraction?
- A. Valvular aortic stenosis
- B. Hypertrophic obstructive cardiomyopathy
- C. Valvular pulmonic stenosis
- D. Mitral valve prolapse
Correct Answer: D
Rationale: Mitral valve prolapse does not typically increase in intensity after a premature ventricular contraction.
Which statement by the mother of a child with rheumatic fever (RF) shows she has a good understanding of the care of her child?
- A. I will apply heat to his swollen joints to promote circulation.
- B. I will have him do gentle stretching exercises to prevent contractures.
- C. I will give him the aspirin that is ordered for pain and inflammation.
- D. I will apply cold packs to his swollen joints to reduce pain.
Correct Answer: C
Rationale: Aspirin is the drug of choice for treating RF due to its anti-inflammatory and analgesic properties.
A child born with Trisomy 21 should be evaluated for which associated cardiac manifestation?
- A. Systemic hypertension
- B. Congenital heart defect
- C. Hyperlipidemia
- D. Cardiomyopathy
Correct Answer: B
Rationale: Children with Trisomy 21 (Down syndrome) have a high incidence of congenital heart defects, such as atrioventricular septal defects, and should be evaluated for these conditions.