Nokea
Klinefelter's syndrome:
- A. Has a karyotype XXV
- B. Is the result of meiotic non-dysjunction
- C. Shows delay in bone age/maturation
- D. Is a recognised cause of hypogonadotrophic hypogonadism
Correct Answer: B
Rationale: Klinefelter's syndrome is caused by meiotic non-dysjunction, resulting in an extra X chromosome (karyotype XXY). It is not inherited as an X-linked recessive trait, and it is not a cause of hypogonadotrophic hypogonadism.
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Which is a clinical manifestation of the systemic venous congestion that can occur with heart failure?
- A. Tachypnea
- B. Tachycardia
- C. Peripheral edema
- D. Pale, cool extremities
Correct Answer: C
Rationale: Peripheral edema, especially periorbital edema, is a clinical manifestation of systemic venous congestion. Tachypnea is a manifestation of pulmonary congestion. Tachycardia and pale, cool extremities are clinical manifestations of impaired myocardial function.
During a well-child checkup for an infant with tetralogy of Fallot (TOF), the child develops severe respiratory distress and becomes cyanotic. The nurse's first action should be to:
- A. Lay the child flat to promote hemostasis
- B. Lay the child flat with legs elevated to increase blood flow to the heart
- C. Sit the child on the parent's lap, with legs dangling, to promote venous pooling
- D. Hold the child in knee-chest position to decrease venous blood return
Correct Answer: D
Rationale: The knee-chest position increases systemic vascular resistance (SVR), which increases blood flow to the pulmonary artery.
Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect?
- A. A loud, harsh murmur with a systolic thrill
- B. Cyanosis when crying
- C. Blood pressure higher in the arms than in the legs
- D. A machinery-like murmur
Correct Answer: A
Rationale: A loud, harsh murmur combined with a systolic thrill is characteristic of a ventricular septal defect.
Increased pulmonary markings (increased pulmonary blood flow) is seen in
- A. pulmonary atresia
- B. truncus arteriosus
- C. tetralogy of Fallot
- D. tricuspid atresia
Correct Answer: B
Rationale: Truncus arteriosus results in increased pulmonary blood flow leading to increased pulmonary markings on chest X-ray.
All of the following are true regarding transient neonatal pustular melanosis, except
- A. Increased melanization of epidermal cells is characteristic
- B. Active phase shows intracorneal or subcorneal pustules filled with eosinophils
- C. Pustular phase rarely lasts more than 2-3 days
- D. Lesions of pustular melanosis do not contain bacteria
Correct Answer: B
Rationale: The active phase of transient neonatal pustular melanosis shows pustules filled with neutrophils, not eosinophils.