Nokea
A 5 months child is brought for routine care. During auscultation of heart you find a short systolic murmur at left upper sternal border with soft 2nd heart sound. The most likely diagnosis is?
- A. Ventricular septal defect
- B. Atrial septal defect
- C. Patent ductus arteriosus
- D. Pulmonary stenosis
Correct Answer: B
Rationale: Atrial septal defect (ASD) often presents with a systolic ejection murmur at the left upper sternal border and a fixed split second heart sound.
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Which of the ff should qualify as an abnormal result in a Romberg test?
- A. Hypotension
- B. Swaying, losing balance, or arm drifting
- C. Sneezing and wheezing
- D. Excessive cerumen in the outer ear
Correct Answer: B
Rationale: During a Romberg test, the individual is asked to stand with feet together, arms at sides, and eyes closed. The tester then observes for swaying, losing balance, or arm drifting, which are signs of a positive Romberg test, indicating a potential issue with proprioception or vestibular function. Hypotension (choice A) refers to low blood pressure and is not directly assessed during a Romberg test. Sneezing and wheezing (choice C) are unrelated symptoms. Excessive cerumen in the outer ear (choice D) does not affect the results of a Romberg test focused on balance and proprioception.
Which of the following method if used by Wilma will best assure that the tracheostomy ties are not too tightly placed?
- A. Wilma places 2 fingers between the tie and neck
- B. The tracheotomy can be pulled slightly away from the neck
- C. James' neck veins are not engorged
- D. Wilma measures the tie from the nose to the tip of the earlobe and to the xiphoid process
Correct Answer: A
Rationale: Placing 2 fingers between the tracheostomy tie and the neck is a reliable method to ensure that the tie is not too tight. This technique allows for proper circulation around the neck area and helps prevent skin irritation or pressure ulcers from developing. It strikes a balance between securing the tracheostomy in place and maintaining the patient's comfort and safety. Checking for appropriate tightness by using the finger method is a standard practice in tracheostomy care to prevent complications related to excessive pressure or constriction.
HIV antibody testing procedures using a finger stick or venipuncture to obtain whole blood, plasma, or serum, and tests using oral fluid were approved. All the following regarding this test are true EXCEPT
- A. they are simple and accurate as to render the likelihood of an erroneous result by the user negligible
- B. a positive result does not need confirmation by Western blot analysis or immunofluorescence assay
- C. they allow women who have not been tested or are unaware of their HIV status to reduce the risk of mother-to-child transmission of antiretroviral therapy implementation
- D. they significantly reduce the risk of mother-to-child transmission
Correct Answer: B
Rationale: A positive result from rapid HIV tests still requires confirmation with more specific tests like Western blot or immunofluorescence assay.
Of the following, the MOST likely cause of constipation is
- A. hypothyroidism
- B. Hirschsprung disease
- C. functional constipation
- D. celiac disease
Correct Answer: C
Rationale: Functional constipation is the most common cause of constipation in children, often due to diet or behavioral factors.
In fetal period, all are true EXCEPT
- A. 10 weeks - midgut returns to abdomen
- B. 12 weeks - external genitalia formed
- C. 24 weeks - surfactant production begun
- D. 26 weeks - face clearly recognizable
Correct Answer: D
Rationale: Face recognition typically occurs earlier than 26 weeks.