Nokea
While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?
- A. Decreased platelet count
- B. Decreased ferritin level
- C. Respiratory alkalosis
- D. Polycythemia
Correct Answer: D
Rationale: Polycythemia is often seen in infants with congenital heart defects that cause decreased pulmonary blood flow, as the body produces more red blood cells to compensate for low oxygen levels.
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What are FOUR possible causes of left axis deviation in a newborn with features of Trisomy 21?
- A. AVSD
- B. Tricuspid atresia
- C. Pulmonary atresia with intact ventricular septum
- D. Mechanical shift
Correct Answer: A
Rationale: AVSD is a common congenital heart defect associated with Trisomy 21 and can lead to left axis deviation seen on ECG.
Which physiological changes occur as a result of hypoxemia in congestive heart failure (CHF)?
- A. Polycythemia and clubbing
- B. Anemia and barrel chest
- C. Increased white blood cells and low platelets
- D. Elevated erythrocyte sedimentation rate and peripheral edema
Correct Answer: A
Rationale: Hypoxemia stimulates erythropoiesis, causing polycythemia, which along with chronic hypoxemia can lead to digital clubbing.
All of the following are true regarding proximal renal tubular acidosis, except
- A. Growth failure in the first few years of life is a characteristic presentation
- B. Urine pH cannot be reduced to < 5.5
- C. It is usually a component of Fanconi syndrome
- D. Non-anion gap metabolic acidosis is common
Correct Answer: D
Rationale: Proximal renal tubular acidosis is associated with a normal anion gap metabolic acidosis, not a non-anion gap metabolic acidosis.
A grade II vibratory, mid-systolic murmur at the mid sternal border in a 4-year-old child that is louder when the child is supine is most likely which type of murmur?
- A. Pathologic murmur
- B. Pulmonary flow murmur
- C. Still's murmur
- D. Venous hum
Correct Answer: C
Rationale: A Still's murmur is characterized by a vibratory or musical low-grade sound, along the sternal border, which is louder when the child is supine or during inspiration.
In childhood asthma:
- A. Over 90% of patients show exercise-induced bronchoconstriction
- B. Hypercapnia is the first physiological disturbance in status asthmaticus
- C. Infants are unresponsive to bronchodilators
- D. Spontaneous cure occurs before adolescence
Correct Answer: D
Rationale: Spontaneous cure before adolescence is a recognized phenomenon in childhood asthma, though not all cases resolve. Other options are incorrect: exercise-induced bronchoconstriction is common but not universal, hypercapnia occurs late in status asthmaticus, and infants do respond to bronchodilators.