Nokea
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.
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The following diseases have diagnostic EEG findings:
- A. Petit mal epilepsy
- B. Infantile spasms
- C. Acute measles encephalopathy
- D. Herpes encephalitis
Correct Answer: B
Rationale: Infantile spasms, also known as West syndrome, have a characteristic EEG pattern called hypsarrhythmia, which is diagnostic.
Treatment options in the management of an intussusception include:
- A. Contrast enema
- B. Air enema
- C. Water enema
- D. Open surgery
Correct Answer: B
Rationale: Air enema is a common non-surgical treatment for intussusception. Contrast enema and open surgery are also options, but air enema is often preferred.
What is the most likely congenital heart lesion in a newborn with Trisomy 21?
- A. AVSD
- B. Tetralogy of Fallot
- C. Ventricular septal defect
- D. Pulmonary stenosis
Correct Answer: A
Rationale: Atrioventricular septal defect (AVSD) is highly associated with Trisomy 21 and is the most likely congenital heart lesion in these infants.
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.
Duchenne muscular dystrophy (DMD):
- A. Affects dystrophin gene
- B. Features usually present before five years of age
- C. Frontal baldness occurs
- D. Is part of the differential diagnosis in a floppy infant
Correct Answer: B
Rationale: Features usually present before five years of age