Nokea
A 4-year-old child has had fever, malaise, and vomiting and right-sided abdominal pain for 48 hours. The following are likely diagnoses:
- A. Acute pyelonephritis
- B. Shigella dysentery
- C. Ascaris lumbricoides infestation, if the child is living in the tropics
- D. Right sided tumour
Correct Answer: A
Rationale: Acute pyelonephritis is a common cause of fever, vomiting, and abdominal pain in children. Shigella dysentery typically causes diarrhea, and Ascaris infestation is rare in non-tropical regions. A right-sided tumour is unlikely without other signs.
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Blunt or shallow Y descent in jugular venous waveform is seen in all, except
- A. Tricuspid stenosis
- B. Cardiac tamponade
- C. Effusive-constrictive pericarditis
- D. Ebstein's anomaly
Correct Answer: D
Rationale: Ebstein's anomaly is not typically associated with a blunt or shallow Y descent in the jugular venous waveform.
Features of severe haemophilia A include:
- A. Retroperitoneal bleed
- B. Chronic arthropathy
- C. Prolonged bleeding time
- D. Increased APTT
Correct Answer: D
Rationale: Increased activated partial thromboplastin time (APTT) is a characteristic feature of haemophilia A due to the deficiency of clotting factor VIII.
An overweight, young adult made who was recently diagnosed with type 2 diabetes mellitus is admitted for a hernia repair. He tells the nurse that he is feeling very weak and jittery. Which actions should the nurse implement? (Select all that apply.)
- A. Check his fingerstick glucose level
- B. Assess his skin temperature and moisture
- C. Measure his pulse and blood pressure
- D. Document anxiety on the surgical checklist
Correct Answer: C
Rationale: These actions help assess for hypoglycemia, a common issue in diabetic patients, and ensure appropriate intervention.
The blood pressure in the right arm is 95/70, and in the lower extremity it is 45/25. The most likely diagnosis is
- A. patent ductus arteriosus
- B. truncus arteriosus
- C. asplenia
- D. coarctation of the aorta
Correct Answer: D
Rationale: Coarctation of the aorta causes a significant difference in blood pressure between the upper and lower extremities.
The following are major side effects of PGE1 EXCEPT
- A. apnea
- B. fever
- C. cutaneous flushing
- D. hypertension
Correct Answer: D
Rationale: Cutaneous flushing is a common side effect of PGE1, while hypertension is not typically observed.