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| Section | Weight | Objectives |
|---|---|---|
| General Assessment | 15% | - Neonatal assessment
|
| Professional Issues | 3% | - Quality improvement and patient safety
|
| Pharmacology | 9% | - Common drug therapies
|
| Embryology, Physiology, Pathophysiology and Systems Management | 54% | - Neurological
|
| General Management | 19% | - Thermoregulation
|
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NEW QUESTION # 123
The NP is caring for a child with end stage renal disease. A sign that he may be in fluid overload is
Answer: B
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 # 124
On examining the neonate, the NP notes 9 cafe au lait spots with a diameter greater than
5 mm and freckles on the axilla and inguinal are
a. The infant should be tested for
Answer: A
Explanation:
Cafe au lait spots (CAL) are flat skin lesions with increased melanin content and regular or irregular borders. If the CAL spots are faint, one can use a Wood lamp to make them easier to see.
Fewer than 3 cafe au lait spots have no clinical significance. However, 6 or more cafe au lait spots with a diameter larger than 5 mm occur in 95% of patients with neurofibromatosis type 1 (NFI), a disorder of chromosome 17. Lisch nodules on the child's iris and Crowe's sign (freckles on the axilla and inguinal area) corroborate the diagnosis of NFI.
NEW QUESTION # 125
A neonate delivered by Cesarean to a mother who smokes exhibits dyspnea, mild sternal retraction, expiratory grunt, nasal flaring, and poor feeding. ABGs show mild hypoxemia.
The most likely cause is
Answer: A
Explanation:
Transient tachypnea of newborn CT TN) occurs when fluid in the lungs is not adequately absorbed after birth. The neonate usually exhibits symptoms within 36 hours of birth and the condition typically resolves within 3 days. T TN is most common in infants delivered by Cesarean section, but premature birth and mothers who smoke or have diabetes increase risk to infant.
Symptoms include:
*Dyspnea (>60/min).
*Sternal retraction (mild).
*Expiratory grunt.
*Nasal flaring.
*Poor feeding (because of increased respiratory rate).
NEW QUESTION # 126
A female neonate is found to have an imperforate anus with no external opening or dimple on initial physical exam. The abdomen is slightly distended, but the neonate passes some meconium at 24 hours. The type of anomaly this suggests is a
Answer: B
Explanation:
In a high anomaly, the rectum ends above the puborectalis muscles, and internal sphincter is absent. Frequently, there is a rectourethral fistula in males or a rectovaginal fistula in females, allowing passage of some meconium. There may be fistulas to the bladder or perineum. Low anomalies have no external opening, but rectum is otherwise in normal position through the puborectalis muscle, with normal function, and no connection to the genitourinary tract.
Intermediate anomalies have rectum at or below the level of puborectalis muscle and an anal dimple. The external sphincter is in normal position.
NEW QUESTION # 127
A neonate exhibits the following:
*Long narrow torso with short arms and legs.
*Proximal segment of the limbs (upper arms and thighs) disproportionately short.
*Head large with frontal bossing and midface hypoplasia.
These characteristics are consistent with
Answer: A
Explanation:
Achondroplasia is the most common cause of dwarfism. Bone growth is inhibited as the result of an abnormal gene on chromosome 4. Achondroplasia can be inherited in an autosomal dominant fashion, but the majority of cases (75-80%) occur with spontaneous mutations. Clinical features apparent at birth include a long narrow torso with short arms and legs. The proximal segment of the limbs (upper arms and thighs) is disproportionately short. The head is large, with frontal bossing and midface hypoplasia. A small hump (gibbus) may be present in the mid-to-lower back. Mild, generalized hypotonia may be present.
NEW QUESTION # 128
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