Nokea
Where do the lesions of atopic dermatitis (eczema) most commonly occur in the infant? (Select all that apply.)
- A. Cheeks
- B. Buttocks
- C. Extensor surfaces of arms and legs
- D. Back
Correct Answer: A
Rationale: In infants with atopic dermatitis (eczema), the lesions most commonly occur on the cheeks (option A) and the extensor surfaces of the arms and legs (option C). The cheeks are a common site of involvement due to increased exposure to irritants and saliva from drooling. The extensor surfaces of the arms and legs are also frequently affected due to scratching and rubbing against clothing. While atopic dermatitis can occur in other areas such as the buttocks, back, and trunk, the cheeks and extensor surfaces are the most common locations in infants.
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The couple with the lowest risk of having a child with sickle cell disease is the one in which the:
- A. Father is HbS and mother is HbS
- B. Father is HbAS and the mother is
- C. Father is HbS and mother is HbAS HbAS
- D. Father is HbA and the mother is HbS
Correct Answer: D
Rationale: Sickle cell disease is an autosomal recessive genetic disorder caused by a mutation in the HBB gene, resulting in the production of abnormal hemoglobin called HbS. In order to have a child with sickle cell disease, both parents must be carriers of the HbS gene.
Phenylketonuria (PKU) is a genetic disease that results in the body's inability to correctly metabolize:
- A. glucose.
- B. phenylalanine.
- C. phenylketones.
- D. thyroxine.
Correct Answer: B
Rationale: Phenylketonuria (PKU) is a genetic disorder that affects the body's ability to metabolize the amino acid phenylalanine. Individuals with PKU lack an enzyme called phenylalanine hydroxylase, which results in the buildup of phenylalanine in the body. If untreated, high levels of phenylalanine can lead to intellectual disabilities, seizures, and other serious health problems. Therefore, individuals with PKU need to follow a special diet low in phenylalanine to prevent these complications.
An insulin-dependent diabetic delivered a 10-pound male. When the baby is brought to the nursery, the priority of care is to
- A. clean the umbilical cord with Betadine to prevent infection
- B. give the baby a bath
- C. call the laboratory to collect a PKU screening test
- D. check the baby's serum glucose level and administer glucose if < 40 mg/dL
Correct Answer: D
Rationale: The priority of care when a baby born to an insulin-dependent diabetic mother is brought to the nursery is to check the baby's serum glucose level and administer glucose if it is less than 40 mg/dL. Babies born to diabetic mothers, especially those with poorly controlled blood sugar levels, are at risk for hypoglycemia (low blood sugar) due to the sudden drop in glucose supply after delivery. Hypoglycemia can be dangerous for newborns and can lead to serious complications if left untreated. Therefore, monitoring the baby's serum glucose levels and providing appropriate intervention, such as administering glucose if necessary, is critical to ensure the baby's well-being.
During a breast examination, which finding most strongly suggests that the client has breast cancer?
- A. Slight asymmetry of the breasts
- B. A fixed nodular mass with dimpling of the overlying skin
- C. Bloody discharge from the nipple
- D. Multiple firm, round, freely movable masses that change with the menstrual cycle
Correct Answer: B
Rationale: A fixed nodular mass with dimpling of the overlying skin is the finding that most strongly suggests breast cancer. This presentation is concerning for an invasive carcinoma that has invaded into the surrounding tissues, leading to the dimpling of the skin. Breast cancer typically presents as a painless, hard, irregularly shaped, non-mobile mass. Dimpling of the skin overlying the mass is a sign of advanced disease and is often associated with a poor prognosis. Therefore, this finding should raise suspicion for breast cancer and prompt further evaluation and workup.
Which blood gas analyses are most indicative of respiratory acidosis?
- A. pH = 7.22, PCO2 = 55 mmHg, HCO3 = 30 mEq/L.
- B. pH = 7.28, PCO2 = 45 mmHg, HCO3 = 15 mEq/L.
- C. pH = 7.34, PCO2 = 35 mmHg, HCO3 = 25 mEq/L.
- D. pH = 7.40, PCO2 = 25 mmHg, HCO3 = 30 mEq/L.
Correct Answer: A
Rationale: Respiratory acidosis is indicated by a low pH and elevated PCO2, as seen in option A.