A NNP is admitting a newborn infant to the unit; he was delivered at 30-weeks gestation. At birth, the infant weighs 1500 gm (low), but otherwise appeared normal. Soon after birth, the infant becomes cyanotic and breathes with a grunting noise. Chest X-rays reveal dense lungs with significant atelectasis but no cardiovascular abnormalities. This is most suggestive of , which is due in part to inadequate production and secretion. As the weeks progress, the neonate had significant complications, including intraventricular hemorrhage, which has left the baby with neurological deficits. The NNP believes the condition resulted in significant areas of brain cell death, which involves necrosis.   

What part of the PCR mix ensures that only the gene of interest is amplified?

How many fragments do you expect to see upon gel electrophoresis of your pCR4-TOPO+insert plasmid,EcoRI digest if your insert contains two EcoRI sites? (Assume complete digestion and all resulting fragments are visualized on the gel).

What was the purpose of the miniprep procedure? 

A 1-month-old premature male infant with bronchopulmonary dysplasia (BPD) remains intubated and monitored in the NICU. He has been doing relatively well and is being gradually weaned from the respirator. The NNP notes his mother, an 18-year-old woman, is crying next to her baby’s bassinet. The NNP asks what is wrong, and she states she has a horrible headache and goes on to describe these recurrent headaches that mainly occur above her right eye and right side of her head. She describes them as “throbbing” in quality. During these headaches, she gets bouts of nausea and vomiting. After a nap, she typically feels better, but she doesn’t want to leave her baby today. The headaches only last a few hours, and she experiences them roughly 2 times a month. She blurts out that she is very scared and worried that she has a brain tumor and is going to die and leave her baby. The NNP tells the mother that she needs to see her care provider, as the headaches are suggestive of a . Several hours after the NNP provides emotional support to the mother, her infant’s O2 saturations and heart rate plummet, and he becomes very dusky. On quick exam, there are decreased breath sounds on the right with an asymmetric chest rise, which is most suggestive of . Given this finding and the acute respiratory distress & hypoxia, the arterial blood gases would like demonstrate .

The PNP is seeing a 14-year boy for a pre-participation sports physical. He hopes to play as a wide receiver on his high school’s football team. The PNP reviews his medical history. He was diagnosed with generalized tonic-clonic seizures at age 6. Seizure disorders in children are the result of . He is well-controlled on valproic acid, having had only 2 seizures in the past 3 years, both associated with an intercurrent illness. There is no history of status epilepticus, head trauma, or other neurologic abnormalities, and he maintains a C+ average in school, as he struggles due to a learning disability, which is defined as . Past medical history is otherwise unremarkable. Growth and development have been normal and immunizations are current, except for his HPV immunization, which his mother declined, despite your education that it would decrease his risk for . Vital signs are normal. Examination is unremarkable. The PNP clears him to play football. 

Kennedy is working with a young child.  She is 16 months is not talking.  The child is playing with a doll and producing the canonical syllable /ba/. Kennedy recognizes that this is a referent for the baby. Kennedy says, “You are holding the baby!” with sing-song intonation.  The child then switches toys and plays with a ball.  She engages in vocal play, without referential intent.  Kennedy imitates her sounds (as precise as possible), and models sound combinations outside her repertoire when the child is demonstrating vocal play.  Kennedy is: (best answer)

Bacteria that have the plasmid shown are resistant to what antibiotic(s)? 

The NNP orders a to test her patient for cystic fibrosis (CF).  Following a thorough examination and positive results on the above testing, the newborn is diagnosed with cystic fibrosis. The NNP tells the parents about the disease, which mainly affects the systems. The NNP provides education to the parents regarding the recurrence risk of future biological offspring having CF. The risk is % for each subsequent pregnancy. As the child grows, special dietary considerations of will likely need to be implemented due to the impact of the disease on the .

A WHNP is seeing RC, a 25-year-old woman, who comes to your office complaining of increasing fatigue and occasional heart palpitations over the last several weeks. She occasionally feels short of breath while having the palpitations, but denies any fever, chills, or weight loss during this time. She does not have a history of asthma or any cardiac problems. She has never had symptoms like this before. PMH: Seasonal allergies. Last menstrual period was 1 week prior. Her periods are moderately heavy, lasting 5 to 7 days, cycling regularly every 30 days. She is not taking any medications. Physical Exam: Temp 36.2 C; Heart rate 72 beats/min; blood pressure 125/72 mmHg. Her conjunctiva look pale, and she has a soft systolic murmur heard best at the left second intercostal space. The rest of the exam is unremarkable. Labs: Hgb 10 g/dL (low); Hct 30% (low); MCV 76 fL (low); serum iron 40 μg/dL (low); transferrin 450 μg/dL (high); ferritin 8 μg/dL (low). The WHNP diagnoses this as a , which appears to be due to . In this demographic, the most common reason for this disorder is due to .