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| Section | Weight | Objectives |
|---|---|---|
| General Management | 19% | - Fluids and electrolytes
|
| Pharmacology | 9% | - Drugs and breastfeeding
|
| General Assessment | 15% | - Discharge planning and follow-up care
|
| Professional Issues | 3% | - Quality improvement and patient safety
|
| Embryology, Physiology, Pathophysiology and Systems Management | 54% | - Infectious diseases
|
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NEW QUESTION # 105
The NP is checking the blood pressure of a newborn. It is 64/40. What should the next step be?
Answer: C
Explanation:
A normal newborn blood pressure is 64/41. This usually rises to 95/58 around the first month of age. Premature infants will have even lower blood pressures unless their medical condition results in an elevation in blood pressure. In this situation, the NP should record the reading and continue with the newborn assessment.
NEW QUESTION # 106
A neonate has had frequent blood draws to monitor electrolyte and glucose levels. This phlebotomy has caused anemia of prematurity (AOP) although the infant is not acutely hypoxemic. The initial treatment is
Answer: C
Explanation:
repo is indicated to stimulate erythropoiesis in phlebotomy-related AOP. Infants with signs of hypoxemia (poor feeding, tachypnea, tachycardia, pallor) may require transfusions. AOP represents a pathologic exaggeration of the normal decrease in hematocrit that occurs in every newborn. Other causes include:
*Decreased RBC production because the premature neonate's response to erythropoietin
*CEPO), the main stimulus for RBC production, has not matured. Lowest Hgb levels are usually at 2-3 months of age.
*Premature RBCs have a shortened lifespan when compared to the full term neonate's
*because of decreased levels of intracellular ATP and enzyme activity.
NEW QUESTION # 107
A neonate receiving mechanical ventilation has a PaC02 level of 33 mmHg with pH of 7.5 from a blood sample obtained from the umbilical artery. These values indicate
Answer: A
Explanation:
These values indicate respiratory alkalosis from hyperventilation associated with excessive mechanical ventilation, which decreases the level of carbon dioxide in the blood. Respiratory alkalosis occurs with PaC02 <35 mmHg and pH >7.45. Normal PaC02 is 35-45 mmHg and normal pH
7.35-7.45. Arterial blood gas (ABG) is the most informative measurement of blood gas status.
Venous blood gas (VBG) is easier to obtain if an arterial catheter is not in place. To compare the values in the VBG with an ABG, add 0.05 to the pH of the VBG. Subtract 5-10 mmHg from the PC02 of the VBG. Capillary blood gas (CBG) can be obtained with a heel stick, but the values obtained are the least accurate and rarely useful.
NEW QUESTION # 108
A neonate born to an HIV-infected mother should receive the first dose of antiretroviral medication within
Answer: B
Explanation:
Antiretroviral medications should be given to the neonate for the first 6 weeks of life with the first dose given within the first 6-12 hours after delivery. The perinatal transmission rate is
30% in untreated HIV positive mothers, usually acquired during delivery; however, optimal treatment reduces perinatal transmission rate to as low as 1-2%. Preventive treatment includes:
*Antiviral therapy during pregnancy: A reduced viral load in the mother lessens the
*likelihood of prenatal transmission.
*Elective Cesarean before the amniotic membranes rupture.
*Avoidance of breastfeeding: The risk of HIV transmission with breastfeeding is 0.7% per month of breastfeeding.
NEW QUESTION # 109
The NP is caring for a child with end stage renal disease. A sign that he may be in fluid overload is
Answer: C
Explanation:
Some of the signs of fluid overload include increased blood pressure, swelling in the extremities and face, abdominal bloating, shortness of breath, and tachycardia. The NP will monitor the patient regularly for any of these symptoms. If the patient will be discharged home, the parents and/or caregivers will also need to be educated on these symptoms.
NEW QUESTION # 110
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