Nokea
The following statements about immunoglobulins are false:
- A. IgG is not transferable across the placenta
- B. IgM is usually a pentamer
- C. IgE levels are raised in parasitic infestations
- D. IgD is important in antibody dependent cytotoxicity
Correct Answer: A
Rationale: IgG is not transferable across the placenta: IgG is the only immunoglobulin that crosses the placenta to provide passive immunity to the fetus.
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Down syndrome and VSD
- A. Doesn't close spontaneously as in children without downs
- B. Inaudible murmur is a characteristic feature / Murmur is not audible
- C. Pulmonary Hypertension is a late complication
- D. If no murmur, condition need not be investigated
Correct Answer: C
Rationale: Pulmonary hypertension is a known late complication in Down syndrome with VSD.
Regarding bronchial asthma:
- A. Mortality has shown an increase during the past three decades
- B. The incidence is greater in males than females
- C. Nocturnal cough is a recognised feature
- D. Post-RSV bronchial hyperreactivity is strongly associated with atopy
Correct Answer: C
Rationale: Nocturnal cough is a common and recognized feature of bronchial asthma, often disrupting sleep.
A harsh, blowing grade IV/VI murmur is auscultated in a 6-month-old infant. What will the nurse practitioner do next?
- A. Get a complete blood count to rule out severe anemia.
- B. Obtain an electrocardiogram to assess for arrhythmia.
- C. Order a chest radiograph to evaluate for cardiomegaly.
- D. Refer to a pediatric cardiologist for further evaluation.
Correct Answer: D
Rationale: A harsh, blowing murmur is suspicious for pathology, so a cardiology referral is warranted.
An 8-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than _____ beats/min.
- A. 60
- B. 70
- C. 90
- D. 100
Correct Answer: B
Rationale: If a 1-minute apical pulse is less than 70 beats/min for an older child, the digoxin is withheld; 60 beats/min is the cut-off for holding the digoxin dose in an adult. A pulse below 90 to 110 beats/min is the determination for not giving a digoxin dose to infants and young children.
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.