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Nursing Neonatal Nurse Practitioner Exam Sample Questions (Q54-Q59):
NEW QUESTION # 54
The initial treatment for patent ductus arteriosus (PDA) for a preterm neonate is usually
- A. prostaglandin
- B. indomethacin or ibuprofen lysine
- C. surgical ligation
Answer: B
Explanation:
Patent ductus arteriosus (PDA) is failure of the ductus arteriosus that connects the pulmonary artery and aorta to close after birth, resulting in left to right shunting of blood from the aorta back to the pulmonary artery. This increases the blood flow to the lung and causes an increase in pulmonary hypertension that can result in damage to the lung tissue. Treatment for PDA:
*Indomethacin (Indocin@) or ibuprofen lysine given within 10 days of birth is successful in closing about 80% of defects.
*Surgical repair with ligation of the patent vessel if conservative treatment is unsuccessful.
NEW QUESTION # 55
What are the most common symptoms of sudden withdrawal of a beta blocker medication?
- A. Hallucinations, seizures, and irritability
- B. Hypertension, increased heart rate, cardiac dysrhythmias, tremors, and sweating
- C. Hypotension, decreased heart rate, fatigue, and lethargt
Answer: B
Explanation:
Therapeutic drugs can cause withdrawal symptoms when they are stopped suddenly, especially if the patient has been taking them for a long period of time. The primary mechanism of action of beta blockers is to decrease heart rate, thereby decreasing blood pressure, and decreasing the risk of developing a cardiac dysrhythmia. When the medication is stopped suddenly, the opposite effect is seen with a significant response. This includes high blood pressure, elevated heart rate, and risk of cardiac dysrhythmias, tremors, and sweating.
NEW QUESTION # 56
An infant with a known congenital diaphragmatic hernia is born at 38 weeks gestation.
He requires resuscitation shortly after delivery due to the weakening of the diaphragm from the herni a. Generally speaking, survival rate for this infant is
- A. higher than another infant requiring resuscitation without a diaphragmatic hernia
- B. equal to that of another infant requiring resuscitation without a diaphragmatic hernia
- C. lower than another infant requiring resuscitation without a diaphragmatic hernia
Answer: C
Explanation:
With a diaphragmatic hernia, the diaphragm becomes weakened and this can result in the stomach and other abdominal contents expending into the chest cavity. This, along with the weakened diaphragm, can result in a decreased ability to breathe. If detected in the prenatal period, assistance can standby during delivery to begin resuscitative measures promptly and improve the chances for survival.
NEW QUESTION # 57
What is the difference between measuring a total bilirubin and a direct bilirubin?
- A. Total bilirubin is the amount of bilirubin bound to albumin, while direct bilirubin is the total
- B. Total bilirubin is the amount of direct and indirect bilirubin, while direct bilirubin is the
- C. Total bilirubin is a measure of the bilirubin excreted through the urine, while direct
Answer: B
Explanation:
Bilirubin is measured as direct indirect, or total. Direct bilirubin is the amount of bilirubin that is not bound to protein that passes from the liver to the small intestines. A small amount passes through the urine to give it a yellow color. The indirect bilirubin is bilirubin that is bound to albumin. The total bilirubin is the measure of both direct and indirect bilirubin combined.
NEW QUESTION # 58
All of the following may be symptoms of hypopituitarism in the newborn EXCEPT
- A. jaundice
- B. increased thirst
- C. hypoglycemia
Answer: B
Explanation:
Of the choices listed, excessive thirst would be seen in an older child with hypopituitarism rather than an infant. The infant with an underfunctioning pituitary gland will exhibit jaundice, hypoglycemia, excessive amounts of urine, sluggishness, and a small penis in male newborns. Older children diagnosed with hypopituitarism will exhibit excessive urination, short stature with weight gain disproportionate to growth, delayed or absent puberty, and delayed tooth eruption.
NEW QUESTION # 59
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