Nokea
The following are suggestive of abnormal language development:
- A. Not localising sound at 4 months of age
- B. No response to human words at 6 weeks
- C. Not understanding 'no' at 18 months of age
- D. Does not move to music at 2 years of age
Correct Answer: C
Rationale: Failure to understand simple commands like 'no' by 18 months is a red flag for abnormal language development.
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A child born with Trisomy 21 should be evaluated for which associated cardiac manifestation?
- A. Systemic hypertension
- B. Congenital heart defect
- C. Hyperlipidemia
- D. Cardiomyopathy
Correct Answer: B
Rationale: Children with Trisomy 21 (Down syndrome) have a high incidence of congenital heart defects, such as atrioventricular septal defects, and should be evaluated for these conditions.
A 5-year-old child who had a repair for transposition of the great arteries shortly after birth is growing normally and has been asymptomatic since the surgery. The primary care nurse practitioner notes mild shortness of breath with exertion and dizziness. What will the nurse practitioner do?
- A. Order an echocardiogram and chest radiograph.
- B. Perform pulmonary function testing.
- C. Reassure the parent that these symptoms are common.
- D. Refer the child to the cardiologist immediately.
Correct Answer: D
Rationale: Children with a history of transposition of the great arteries (d-TGA) who have a history of palpitations, syncope, or shortness of breath should be referred to a cardiologist.
Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood?
- A. The patent ductus arteriosus
- B. A ventricular septal defect
- C. The closure of the foramen ovale
- D. An atrial septal defect
Correct Answer: D
Rationale: Because the right side of the heart must take over pumping blood to both the lungs and systemic circulation, the ductus arteriosus must remain open to shunt the oxygenated blood from the lungs.
A child with rheumatic fever is being admitted to the pediatric floor. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever?
- A. “Has your child complained of back pain?â€
- B. “Has your child complained of headaches?â€
- C. “Has your child had any nausea or vomiting?â€
- D. “Did your child have a sore throat or fever within the last 2 months?â€
Correct Answer: D
Rationale: A history of sore throat or fever within the last 2 months is significant as rheumatic fever often follows a streptococcal infection such as strep throat.
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.