The definition of hypertension in children is
- A. average systolic blood pressure (SBP) and/or diastolic BP that is ≥95th percentile for age, sex, on ≥2 occasions
- B. average systolic blood pressure (SBP) and/or diastolic BP that is ≥95th percentile for age, sex, and height on ≥2 occasions
- C. average systolic blood pressure (SBP) and/or diastolic BP that is ≥95th percentile for age, sex, and height on ≥3 occasions
- D. average systolic blood pressure (SBP) and/or diastolic BP that is ≥90th percentile for age, sex, and height on ≥3 occasions
Correct Answer: C
Rationale: Hypertension in children is defined as BP ≥95th percentile for age, sex, and height on ≥3 occasions.
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The primary care pediatric nurse practitioner is performing a sports physical on an adolescent whose history reveals mild aortic stenosis (AS). What will the nurse practitioner recommend?
- A. Avoidance of all sports to prevent sudden death
- B. Clearance for any sports since this is mild
- C. Evaluation by a cardiologist prior to participation
- D. Low-intensity sports
Correct Answer: C
Rationale: Children with mild AS may participate in any sport but must have annual cardiac evaluations.
Fetal distress is indicated by:
- A. Meconium staining of liquor
- B. Arrhythmias
- C. Tachycardia
- D. Bradycardia
Correct Answer: D
Rationale: The correct answer is D because bradycardia is a key indicator of fetal distress. The other options (a, b, c, e) are less specific or not primary indicators.
An adult female client is diagnosed with restless leg syndrome and is referred to the sleep clinic. The healthcare provider prescribes ferrous sulfate (Feosol) 325 mg PO daily. Which laboratory values should the nurse monitor?
- A. Serum electrolytes
- B. Neutrophils and eosinophils
- C. Serum iron and ferritin
- D. Platelet count and hematocrit
Correct Answer: C
Rationale: Serum iron and ferritin levels should be monitored because they are indicators of iron deficiency, which is a common cause of restless leg syndrome.
Which of the following is correct in breast milk jaundice?
- A. Peaks at first week of life
- B. Recurs with resumption of breast milk after trial stoppage
- C. Kernicterus can occur
- D. Seen in up to 10% of infants
Correct Answer: B
Rationale: Breast milk jaundice recurs when breastfeeding is resumed after a temporary stoppage.
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.
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