Nokea
A 2-year-old child is being treated for lead poisoning. Which of the following findings indicates the need for further intervention?
- A. Increased urine output
- B. Decreased hemoglobin levels
- C. Weight gain
- D. Improved developmental milestones
Correct Answer: B
Rationale: Lead poisoning can cause anemia, so a decrease in hemoglobin levels would indicate that further intervention is necessary.
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The differential diagnosis of the patient includes all of the following EXCEPT
- A. rheumatic fever
- B. SLE
- C. chronic atrial fibrillation
- D. postmeningococcal immune complexes
Correct Answer: C
Rationale: Chronic atrial fibrillation is unlikely in an 8-year-old with acute onset symptoms.
What is one reason why patients with CHD are more likely to have rejection post-transplant than those with cardiomyopathy?
- A. Sensitized recipients with panel reactive antibody (PRA)
- B. Absence of systemic disease
- C. History of good compliance
- D. None of the above
Correct Answer: A
Rationale: Patients with congenital heart disease (CHD) are often sensitized due to prior surgeries and blood transfusions, leading to a higher risk of rejection post-transplant.
A two-year-old child should have been immunised against:
- A. Tetanus
- B. Polio
- C. Measles
- D. Hepatitis A
Correct Answer: C
Rationale: By the age of two, a child should have received the MMR vaccine, which protects against measles, mumps, and rubella.
The parents of a young child with heart failure tell the nurse that they are “nervous†about giving digoxin (Lanoxin). The nurse’s response should be based on which statement?
- A. It is a safe, frequently used drug.
- B. It is difficult to either overmedicate or undermedicate with digoxin.
- C. Parents lack the expertise necessary to administer digoxin.
- D. Parents must learn specific, important guidelines for administration of digoxin.
Correct Answer: D
Rationale: Digoxin has a narrow therapeutic range. The margin of safety between therapeutic, toxic, and lethal doses is very small. Specific guidelines are available for parents to learn how to administer the drug safely and to monitor for side effects. Digoxin is a frequently used drug, but it has a narrow therapeutic range. Small amounts of the liquid are given to infants, making it easy to overmedicate or undermedicate. Parents may lack the necessary expertise to administer the drug at first, but with discharge preparation, they should be prepared to administer the drug safely.
Recognised features of myotonic dystrophy include:
- A. Phenomenon of anticipation
- B. Muscle pain
- C. Diplopia
- D. Cardiomyopathy
Correct Answer: A
Rationale: The phenomenon of anticipation, where symptoms become more severe or appear at an earlier age as the disorder is passed through generations, is a recognized feature of myotonic dystrophy.