Nokea
Which drug should not be used to control secondary hypertension in a sexually active adolescent female who uses intermittent birth control?
- A. Beta blockers
- B. Calcium channel blockers
- C. ACE inhibitors
- D. Diuretics
Correct Answer: C
Rationale: ACE inhibitors and angiotensin II receptor blockers are teratogenic and should be avoided in sexually active adolescents using birth control.
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The following features are more suggestive of biliary atresia rather than neonatal hepatitis in an infant 6 weeks of age:
- A. Hepatomegaly
- B. Prolonged INR (prothrombin time)
- C. Biopsy specimen showed proliferation of bile ductules, periportal fibrosis and bile lakes
- D. HillA scan reveals delayed uptake and excretion of the contrast material
Correct Answer: C
Rationale: Proliferation of bile ductules, periportal fibrosis, and bile lakes on biopsy are hallmark features of biliary atresia.
Common causes of recurrent haematuria are:
- A. Berger's disease
- B. Goodpasture's syndrome
- C. Renal stones
- D. Acute post-streptococcal glomerulonephritis
Correct Answer: A
Rationale: The correct answer is A because Berger's disease (IgA nephropathy) is a common cause of recurrent haematuria. The other options (b-e) are less common or present differently.
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.
Which action by the school nurse is important in the prevention of rheumatic fever?
- A. Encourage routine cholesterol screenings.
- B. Conduct routine blood pressure screenings.
- C. Refer children with sore throats for throat cultures.
- D. Recommend salicylates instead of acetaminophen for minor discomforts.
Correct Answer: C
Rationale: Nurses have a role in prevention—primarily in screening school-age children for sore throats caused by group A β-hemolytic streptococci. They can achieve this by actively participating in throat culture screening or by referring children with possible streptococcal sore throats for testing. Cholesterol and blood pressure screenings do not facilitate the recognition and treatment of group A β-hemolytic streptococci. Salicylates should be avoided routinely because of the risk of Reye syndrome after viral illnesses.
The patient experiences a headache and is unable to move the left side of his body. The most likely cause is
- A. embolic stroke
- B. cerebral thrombosis
- C. cerebral abscess
- D. moyamoya disease
Correct Answer: A
Rationale: Embolic stroke is a common complication of cyanotic congenital heart disease.