Nokea
While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has:
- A. Pulmonary hypertension
- B. Patent ductus arteriosus (PDA)
- C. Ventricular septal defect (VSD)
- D. Bronchopulmonary dysplasia
Correct Answer: B
Rationale: A machine-like murmur is the hallmark of a PDA.
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Recognised features of ABO incompatibility include:
- A. Normal haemoglobin on day 1
- B. Worsening with subsequent pregnancies
- C. Conjugated hyperbilirubinaemia
- D. Negative Coombs test
Correct Answer: A
Rationale: In ABO incompatibility, haemoglobin levels are typically normal on day 1. The condition does not worsen with subsequent pregnancies and is associated with unconjugated hyperbilirubinaemia.
The following statements about immunoglobulins are false:
- A. IgG is not transferable across the placenta
- B. IgM is usually a pentamer
- C. IgE levels are raised in parasitic infestations
- D. IgD is important in antibody dependent cytotoxicity
Correct Answer: A
Rationale: IgG is not transferable across the placenta: IgG is the only immunoglobulin that crosses the placenta to provide passive immunity to the fetus.
After the nurse provides dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching?
- A. “Well follow these instructions until our child’s symptoms disappear.â€
- B. “Our child must maintain these dietary restrictions until adulthood.â€
- C. “Our child must maintain these dietary restrictions lifelong.â€
- D. “We’ll follow these instructions until our child has completely grown and developed.â€
Correct Answer: C
Rationale: Celiac disease requires lifelong adherence to a gluten-free diet to prevent symptoms and complications.
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.
Regarding cystic fibrosis:
- A. It is inherited as autosomal recessive
- B. There is increased risk of bronchial carcinoma in late adulthood
- C. Biliary cirrhosis is a recognised feature
- D. In neonates, intestinal obstruction may be the first presentation
Correct Answer: A
Rationale: Cystic fibrosis is an autosomal recessive disorder caused by mutations in the CFTR gene.