Nokea
Which of the following skills would be expected of a 7-month-old infant but not of a 5-month-old infant?
- A. Crawls
- B. Smiles socially
- C. Controls bowel and bladder
- D. Sits unsupported
Correct Answer: D
Rationale: A 7-month-old can typically sit unsupported, while a 5-month-old cannot. Crawling and social smiling develop earlier, and bowel control is not expected at this age.
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Polycythaemia:
- A. Is a common cause of jaundice in the newborn
- B. Is significant if haematocrit > 65% on a capillary sample
- C. May cause apnoeas
- D. Exchange transfusion is the treatment of choice in symptomatic cases
Correct Answer: B
Rationale: Polycythaemia is considered significant if the haematocrit exceeds 65% on a capillary sample, as it can lead to hyperviscosity and related complications.
Cataracts are recognised in:
- A. Hyperthyroidism
- B. Down syndrome
- C. Graves' disease
- D. PKU
Correct Answer: B
Rationale: Cataracts are a recognized feature in Down syndrome. They are not typically associated with Hyperthyroidism, Graves' disease, or PKU.
An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?
- A. I get short of breath when I climb stairs.
- B. I see halos floating around my head.
- C. I have trouble remembering things.
- D. I have lost weight over the past month.
Correct Answer: A
Rationale: Shortness of breath, especially during exertion, is a classic symptom of heart failure due to the heart's inability to pump blood effectively.
A 3-year-old child diagnosed with congestive heart failure is receiving maintenance doses of digoxin and furosemide (Lasix). She is rubbing her eyes when she is looking at the lights in the room and her heart rate is 65 beats per minute. The nurse expects which laboratory finding?
- A. Hypokalemia
- B. Hypomagnesemia
- C. Hypocalcemia
- D. Hypophosphatemia
Correct Answer: A
Rationale: Hypokalemia is a common side effect of furosemide, a diuretic, and can exacerbate digoxin toxicity, which may present with symptoms such as visual disturbances and bradycardia.
Early features of heart failure in infancy include:
- A. Bradycardia
- B. Oedema
- C. Tachypnoea
- D. Hepatomegaly
Correct Answer: C
Rationale: Tachypnoea is an early indicator of heart failure in infants, as the body tries to compensate for reduced oxygenation by increasing the respiratory rate.