Nokea
The MOST appropriate advice for a 4-year-old child visiting the outpatient department with excessive crying is
- A. reassures her that this is a normal phenomenon
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate for child abuse
Correct Answer: B
Rationale: Further history may help differentiate normal behavior from developmental concerns.
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Which is a function of brown adipose tissue (BAT) in the newborn?
- A. Provides ready source of calories in the newborn period
- B. Insulates the body against lowered environmental temperature
- C. Protects the newborn from injury during the birth process
- D. Generates heat for distribution to other parts of body
Correct Answer: D
Rationale: Brown adipose tissue (BAT) is specialized adipose tissue found in newborns and hibernating mammals, whose primary function is to generate heat through non-shivering thermogenesis. This heat generation is essential for maintaining body temperature in newborns, especially as they have a larger surface area-to-volume ratio, which results in greater heat loss compared to adults. BAT produces heat by metabolizing stored lipids and disrupting the normal process of cellular respiration, leading to the production of heat instead of ATP. The heat generated by BAT is then distributed throughout the body to help maintain a stable core body temperature in newborns, who are not yet able to regulate their body temperature as effectively as adults.
A first-time mother brings in her 5-day-old baby for a well-child visit. The baby weighs 7 lb 5 oz, down from 7 lb 10 oz at discharge. The nurse's best response is:
- A. I will notify the doctor about this weight loss.
- B. Newborns can lose up to 10% of their birth weight and regain it by 2 weeks of age.
- C. I can tell you are a first-time mother; don't worry.
- D. Maybe the baby isn't getting enough milk. How often are you feeding?
Correct Answer: B
Rationale: A small weight loss is normal in the first week of life; infants typically regain their birth weight by 2 weeks.
The most common neonatal sepsis and meningitis infections seen within 24 hours after birth are caused by which organism?
- A. Candida albicans
- B. Chlamydia trachomatis
- C. Escherichia coli
- D. Group B beta-hemolytic streptococci
Correct Answer: C
Rationale: Escherichia coli is the most common cause of early-onset neonatal sepsis and meningitis within 24 hours after birth. E. coli can be transmitted from the mother to the infant during delivery, particularly if there is prolonged rupture of membranes or maternal infection. Infections caused by E. coli in newborns can be severe and life-threatening. It is important to identify and promptly treat infections caused by E. coli in neonates to prevent complications and improve outcomes.
If a patient has elevated pulmonary vascular pressures, the nurse understands that the patient is most likely to develop which of the ff. physiological cardiac changes?
- A. Left atrial atrophy
- B. Left ventricular hypertrophy
- C. Right atrial atrophy
- D. Right ventricular hypertrophy
Correct Answer: D
Rationale: Elevated pulmonary vascular pressures can lead to pulmonary hypertension, which causes increased pressure in the right side of the heart. The right ventricle has to work harder to pump blood against the increased resistance in the pulmonary circulation. Over time, this can result in the development of right ventricular hypertrophy as the muscle of the right ventricle thickens in response to the increased workload. This is a compensatory mechanism to try to maintain cardiac output despite the increased pressure in the pulmonary circulation. Left atrial atrophy, left ventricular hypertrophy, and right atrial atrophy are not typically associated with elevated pulmonary vascular pressures.
The beta subunit of human chorionic gonadotropin (HCG) is a useful surface marker in some malignant germ cell tumors (GCTs); it is secreted by syncytiotrophoblasts. In which of the following GCTs this surface marker is characteristically elevated?
- A. teratoma
- B. germinoma
- C. endodermal sinus tumor
- D. embryonal carcinoma
Correct Answer: D
Rationale: Embryonal carcinoma is strongly associated with elevated beta-HCG levels.