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| Section | Weight | Objectives |
|---|---|---|
| General Management | 19% | - Thermoregulation
|
| Professional Issues | 3% | - Evidence-based practice
|
| Pharmacology | 9% | - Pharmacokinetics and pharmacodynamics
|
| General Assessment | 15% | - Discharge planning and follow-up care
|
| Embryology, Physiology, Pathophysiology and Systems Management | 54% | - Metabolic and endocrine
|
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NEW QUESTION # 52
What is the most common cause of a cardiac tamponade in the newborn?
Answer: C
Explanation:
Cardiac tamponade occurs when fluid accumulates with the pericardial sac, causing pressure on the outside of the heart. It is treated by inserting a needle through the chest wall, into the pericardium, and withdrawing the fluid. Though cardiac tamponade in neonates is rare, it can occur in this population when a central venous catheter is in an incorrect position, applying pressure at the juncture of the inferior vena cava and the right atrium. Ensuring correct placement of the catheter is imperative to prevent this life-threatening complication.
NEW QUESTION # 53
What is a patent ductus arteriosus?
Answer: C
Explanation:
PDA is an opening betvveen the pulmonary and aortic arteries. Before a baby is born, its blood is oxygenated by the mother through the placenta. A vessel is formed connecting the pulmonary and aortic arteries, the ductus arteriosus. Shortly after birth, this vessel closes off so that the infants blood can then receive oxygen from its own lungs. With a PDA the ductus arteriosus remains open and oxygen-rich blood from the aorta mixes with the blood lacking oxygen from the pulmonary artery. If the rest of the heart is functioning normal, the baby is monitored and the PDA is allowed to repair itself. If this does not happen, the defect can be surgically corrected.
NEW QUESTION # 54
A neonate is 40 weeks gestation and nursing well but has onset of jaundice at 36 hours.
Total serum bilirubin is 12 mg/dL At this time, treatment should include
Answer: B
Explanation:
While the neonate's bilirubin is elevated (normal range 3.4-11.5 mg/dL at 1-2 days), only continued observation and jaundice assessment is indicated at this time. Physiologic hyperbilirubinemia is common in newborns and usually benign, resulting from immature hepatic function and increased RBC hemolysis. Infants have larger red blood cells with a shorter life than adults, leading to more RBC destruction and resulting in an increased load of serum bilirubin, which the liver of the newborn cannot handle. Onset is usually within 24-48 hours, peaking in 72 hours for full term or 5 days for preterm infants and declining within a week. Phototherapy is the indicated treatment for total serum bilirubin 218 mg/dL for those at medium risk.
NEW QUESTION # 55
An infant with fetal alcohol syndrome may also have a facial deformity known as
Answer: A
Explanation:
Micrognathia, or an underdeveloped jaw, may occur with fetal alcohol syndrome. It can also be seen with trisomy 13 and progeria. The underdeveloped jaw will often resolve on its own as the child grows. In severe cases, it can cause breathing and feeding problems. Microcephaly, not macrocephaly, is also typically seen with fetal alcohol syndrome.
NEW QUESTION # 56
A neonate develops tremors of the chin and extremities with the following observations:
*Lack of ocular deviations or other abnormalities.
*Gentle restraint halts tremors.
*Stimulation elicits tremors.
*Clonic jerking has both fast and slow elements.
*Autonomic changes involving the heart rate, respirations, and blood pressure are not present.
*EEG is normal.
The most likely cause is
Answer: C
Explanation:
Jitteriness is distinct from shuddering, a 10-15 second period of fast tremors that may recur SIOO times daily. Both jitteriness and shuddering are benign findings. Seizures indicate that there is an abnormality of the central nervous system and are differentiated by their associated abnormal movements:
*Subtle: Feet pedaling, chewing, apnea, eye movements, or blank stare.
*Tonic: Tonic flexion or extension of the limbs, focal (one limb) or generalized.
*Clonic: Slow, clonic movements (1-3 per second), often in one extremity or one side of the body.
*Myoclonic: Focal, multi-focal, or generalized, with rapid jerking movements of the extremities.
NEW QUESTION # 57
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