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Recognised features in Marfan's syndrome include:
- A. Mutation in fibrillin gene
- B. Mitral valve prolapse
- C. Cognitive impairment
- D. Myopia
Correct Answer: B
Rationale: Mitral valve prolapse
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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.
A 12-month-old child who had repair of a congenital heart defect at 8 months of age has a normal exam and is not taking any medications. The nurse practitioner will contact the child's cardiologist to discuss whether the child needs which medication?
- A. Amoxicillin
- B. Capoten
- C. Digoxin
- D. Furosemide
Correct Answer: A
Rationale: Children who have had complete repair of congenital heart defect (CHD) should have subacute bacterial endocarditis (SBE) prophylaxis with amoxicillin for 6 months after the procedure.
Recognised causes of delayed speech include:
- A. Hypothyroidism
- B. PKU
- C. Cystinuria
- D. Twins
Correct Answer: A
Rationale: Hypothyroidism is a known cause of delayed speech. PKU and deafness can also cause speech delays, but cystinuria is not associated with speech delay.
A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals vital signs of a regular heart rate of 230 beats per minute, respiratory rate of 30 per minute, BP of 84/52, and capillary refill time of 3 seconds. Which dysrhythmia does the nurse suspect in this child?
- A. Rapid atrial flutter
- B. Supraventricular tachycardia
- C. Sinus bradycardia
- D. Rapid atrial fibrillation
Correct Answer: B
Rationale: Supraventricular tachycardia is characterized by a very rapid heart rate, which can lead to decreased cardiac output and symptoms such as lethargy and difficulty waking, as seen in this toddler.
While assessing a client with degenerative joint disease, the nurse observes Heberden's nodes, large prominences on the client's fingers that are reddened. The client reports that the nodes are painful. Which action should the nurse take?
- A. Review the client's dietary intake of high-protein foods
- B. Notify the healthcare provider of the finding immediately
- C. Discuss approaches to the chronic pain control with the client
- D. Assess the client's radial pulses and capillary refill time
Correct Answer: C
Rationale: Chronic pain management is a priority in clients with degenerative joint disease and Heberden's nodes.