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Question 1 of 5.

Newborns are routinely screened for phenylketonuria. The nursery nurse ensures that this screening test is performed:

A. Immediately after birth, because the most accurate result is obtained at this time

B. After 2-3 days of milk ingestion

C. At 2-3 days of age regardless of amount of milk feedings

D. At 1 month, because the biochemical buildup of phenylalanine takes 1 month to detect

Explanation: The infant has not ingested any protein immediately after birth, which is necessary to detect excessive serum phenylalanine. It is important that the infant take in 2-3 full days of milk or formula feedings to preclude a false-negative reading. At 2-3 days of age, inadequate milk could have been ingested owing to a delay in the initial feeding. The biochemical buildup of serum phenylalanine is detectable after 2-3 days of milk or formula ingestion.

Question 2 of 5.

A diagnosis of multiple sclerosis is often delayed because of the varied symptoms experienced by those affected with the disease. Which symptom is most common in those with multiple sclerosis?

A. Resting tremors

B. Double vision

C. Flaccid paralysis

D. Pill-rolling tremors

Explanation: Double vision (diplopia) is a common early symptom of multiple sclerosis due to demyelination affecting the optic nerves or brainstem.

Question 3 of 5.

A child with Down syndrome has a developmental age of four years. According to the Denver Developmental Assessment, the four-year-old should be able to:

A. Draw a man in six parts

B. Give his first and last name

C. Dress without supervision

D. Define a list of words

Explanation: Per the Denver Developmental Screening Test, a four-year-old should be able to state their first and last name, a milestone achievable despite Down syndrome delays.

Question 4 of 5.

Parents of a toddler are dismayed when they learn that their child has Duchenne's muscular dystrophy. Which statement describes the inheritance pattern of the disorder?

A. An affected gene is located on one of the 21 pairs of autosomes.

B. The disorder is caused by an over-replication of the X chromosome in males.

C. The affected gene is located on the Y chromosome of the father.

D. The affected gene is located on the X chromosome of the mother.

Explanation: Duchenne's muscular dystrophy is an X-linked recessive disorder, with the affected gene on the mother's X chromosome, primarily affecting males.

Question 5 of 5.

The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?

A. Increased pulse rate

B. Increased urinary output

C. Decreased diastolic blood pressure

D. Increased pupil size

Explanation: Mannitol is an osmotic diuretic that reduces intracranial pressure by increasing urinary output, drawing fluid from the brain.

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