Nokea
A child has a Glasgow Coma Scale of 3, HR of 88 beats per minute and regular, respiratory rate of 22, BP of 78/52, and blood sugar of 35 mg/dL. The nurse asks the caregiver about accidental ingestion of which drug?
- A. Calcium channel blocker
- B. Beta blocker
- C. ACE inhibitor
- D. ARB
Correct Answer: B
Rationale: Beta blockers affect the heart and also block beta receptors in the liver, reducing glycogen release and causing hypoglycemia. The low HR and BP support beta blocker ingestion.
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Appropriate initial management steps in an acute anaphylactic reaction to a blood transfusion include:
- A. Nebulised steroids
- B. Oxygen
- C. Intravenous hydrocortisone
- D. Intravenous anti-H2 agent
Correct Answer: B
Rationale: Oxygen is a critical initial management step in anaphylaxis to ensure adequate oxygenation during the acute phase.
Paroxysmal hypercyanotic attacks (hypoxic, blue, or tet spells) are a particular problem during the lst 2 yr of life. They are characterized by
- A. early evening occurrence
- B. an increase in intensity of the systolic murmur
- C. unpredictable onset
- D. metabolic alkalosis
Correct Answer: A
Rationale: Unpredictable onset and metabolic alkalosis are common features of tet spells.
Regarding cisapride:
- A. It is licensed for use in children
- B. Fatal arrhythmias have been reported
- C. Concurrent administration with erythromycin is not advised
- D. It commonly causes constipation
Correct Answer: B
Rationale: Fatal arrhythmias have been reported: Cisapride, a gastrointestinal prokinetic agent, has been linked to fatal arrhythmias, particularly when combined with certain drugs like erythromycin.
All of the following are true regarding attention deficit hyperactivity disorder (ADHD), except
- A. Dopamine transporter gene (DAT1) and dopamine 4 receptor gene (DRD4) are implicated in the diagnosis
- B. Impaired fine motor movement and poor coordination are 'soft' but specific signs of ADHD
- C. Developmentally inappropriate behavior must commence before 7 years of age and present for at least 6 months
- D. Maternal lead exposure is associated with ADHD
Correct Answer: B
Rationale: Impaired fine motor movement and poor coordination are not specific signs of ADHD; they are nonspecific and can occur in other conditions.
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.