Nokea
Recognised features of myotonic dystrophy include:
- A. Phenomenon of anticipation
- B. Muscle pain
- C. Diplopia
- D. Cardiomyopathy
Correct Answer: A
Rationale: The phenomenon of anticipation, where symptoms become more severe or appear at an earlier age as the disorder is passed through generations, is a recognized feature of myotonic dystrophy.
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The causes of elevated maternal serum AFP are:
- A. Trisomy 21
- B. Exomphalos
- C. Marfan syndrome
- D. Meningomyelocele
Correct Answer: D
Rationale: Elevated maternal serum alpha-fetoprotein (AFP) is associated with neural tube defects such as meningomyelocele, due to leakage of AFP into the amniotic fluid.
The nurse is preparing to administer a dose of digoxin (Lanoxin) to a child in heart failure (HF). Which is a beneficial effect of administering digoxin (Lanoxin)?
- A. It decreases edema.
- B. It decreases cardiac output.
- C. It increases heart size.
- D. It increases venous pressure.
Correct Answer: A
Rationale: Digoxin has a rapid onset and is useful for increasing cardiac output, decreasing venous pressure, and, as a result, decreasing edema. Cardiac output is increased by digoxin. Heart size and venous pressure are decreased by digoxin.
A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?
- A. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg
- B. The respiratory rate decreased from 25 breaths/min to 14 breaths/min
- C. Pulse decreased from 100 beats/min to 80 beats/min
- D. Oxygen saturation increased from 88% to 96%
Correct Answer: D
Rationale: Beta blockers reduce heart rate and blood pressure. A decrease in pulse rate from 100 beats/min to 80 beats/min is consistent with the expected pharmacological effect of a beta blocker.
Afterload reducers are not indicated in children with heart failure secondary to
- A. cardiomyopathy
- B. severe mitral insufficiency
- C. aortic stenosis
- D. ventricular septal defect
Correct Answer: C
Rationale: Afterload reducers are contraindicated in conditions where forward flow is already compromised, such as aortic stenosis.
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.