Nokea
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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Pregnancy is contraindicated in mothers with
- A. pulmonary hypertension
- B. ventricular septal defects
- C. prosthetic valves
- D. atrial septal defects
Correct Answer: A
Rationale: Pregnancy is contraindicated in severe pulmonary hypertension and unoperated cyanotic congenital heart disease.
The following statements are true:
- A. Unexplained vaginal discharge in a 3-year-old might be a sign of sexual abuse
- B. Spiral fracture of femur is always non-accidental
- C. Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome
- D. Bruises on the elbows and knees in a 4-year-old are suggestive of physical abuse
Correct Answer: C
Rationale: Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome: Retinal bleeding in infants, especially with other signs of physical abuse, is a key indicator of 'shaken baby' syndrome.
A client with a productive cough has obtained a sputum specimen for culture as instructed. What is the best initial nursing action?
- A. Administer the first dose of antibiotic therapy
- B. Observe the color, consistency, and amount of sputum
- C. Encourage the client to consume plenty of warm liquids
- D. Send the specimen to the lab for analysis
Correct Answer: B
Rationale: Observing the color, consistency, and amount of sputum helps in assessing the nature of the infection and guides further treatment. Sending the specimen to the lab is important but not the first action.
A 12-year-old male tries out for a middle school hockey team. He has a history of a heart murmur as an infant, but the doctor thought it would go away. During the tryout, he experiences severe dyspnea and becomes light-headed. At your office, he has a normal rhythm, pulse, and blood pressure and is no longer dizzy. There is a grade 4/6 systole ejection murmur that radiates to the neck. There is also an ejection click. An ECG reveals left ventricular hypertrophy. The next approach to his management includes
- A. chest x-ray
- B. exercise test
- C. digitalization
- D. echocardiography
Correct Answer: D
Rationale: Echocardiography is essential to evaluate the severity of aortic stenosis and its effects on the heart.
A 16-year-old being treated for hypertension has laboratory values of: Hemoglobin: 16 g/dL Hematocrit: 43% Sodium: 139 mEq/L Potassium: 4.4 mEq/L Total cholesterol: 220 mg/dL Which drug does the nurse suspect the patient takes based on the total cholesterol?
- A. Beta blockers
- B. Calcium channel blockers
- C. ACE inhibitors
- D. Diuretics
Correct Answer: A
Rationale: Beta blockers are used with caution in patients with hyperlipidemia, hyperglycemia, and impotence.