Nokea
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.
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Fetal distress is indicated by:
- A. Meconium staining of liquor
- B. Arrhythmias
- C. Tachycardia
- D. Bradycardia
Correct Answer: D
Rationale: The correct answer is D because bradycardia is a key indicator of fetal distress. The other options (a, b, c, e) are less specific or not primary indicators.
Regarding cafe-au-lait spots:
- A. They can be normal findings
- B. They are found in tuberous sclerosis
- C. When present in a child, > 4 spots each > 0.5 cm, is diagnostic of neurofibromatosis type II
- D. Typical appearance in neurofibromatosis is of a smooth border
Correct Answer: A
Rationale: Cafe-au-lait spots can be a normal variant and do not always indicate an underlying pathology.
A 4-year-old child presents to the clinic with a history of persistent dry cough and wheezing. What is the nurse’s primary concern?
- A. Allergic reaction
- B. Asthma exacerbation
- C. Respiratory infection
- D. Acute bronchiolitis
Correct Answer: B
Rationale: Wheezing and persistent dry cough are hallmark symptoms of asthma exacerbation, which is the nurse's primary concern.
Recognised features of brucellosis include:
- A. Osteomyelitis
- B. Liver granuloma
- C. Pericarditis
- D. Splenomegaly
Correct Answer: D
Rationale: Splenomegaly
In Wolff-Parkinson-White syndrome:
- A. The abnormal pathway is between the atrial and ventricular myocardium
- B. Wide QRS complexes occur more frequently than narrow QRS
- C. Narrow QRS complexes are regular
- D. Verapamil is the treatment of choice for atrial fibrillation
Correct Answer: B
Rationale: In Wolff-Parkinson-White syndrome, a wide QRS complex is often seen due to the presence of an accessory pathway that bypasses the normal conduction system.