Nokea
A child has been seen by the school nurse for dizziness since the start of the school term. It happens when standing in line for recess and homeroom. The child now reports that she would rather sit and watch her friends play hopscotch because she cannot count out loud and jump at the same time. When the nurse asks her if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has:
- A. Ventricular septal defect (VSD)
- B. Aortic stenosis (AS)
- C. Mitral valve prolapse
- D. Tricuspid atresia
Correct Answer: B
Rationale: AS can progress and result in exercise intolerance, which may improve with rest.
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In common variable immunodeficiency (CVID):
- A. B cells are totally absent
- B. There is increased incidence of autoimmune disorders in families of affected members
- C. IgA levels are characteristically normal
- D. T lymphocytes are usually affected
Correct Answer: B
Rationale: CVID is associated with an increased incidence of autoimmune disorders in families of affected individuals.
The MOST common cause of syncope in children is
- A. Wolff-Parkinson-White syndrome
- B. prolonged QT syndrome
- C. atrioventricular block
- D. neurocardiogenic syncope
Correct Answer: D
Rationale: Neurocardiogenic syncope is the most common cause of syncope in children due to autonomic dysfunction.
Recognised features of anorexia nervosa include:
- A. T-wave inversion on ECG
- B. Hypocholesterolaemia
- C. Peripheral oedema
- D. Sinus bradycardia
Correct Answer: D
Rationale: Sinus bradycardia, a slower than normal heart rate, is a recognized feature of anorexia nervosa due to the body's adaptation to starvation.
A client with a productive cough has obtained a sputum specimen for culture as instructed. What is the best initial nursing action?
- A. Administer the first dose of antibiotic therapy
- B. Observe the color, consistency, and amount of sputum
- C. Encourage the client to consume plenty of warm liquids
- D. Send the specimen to the lab for analysis
Correct Answer: B
Rationale: Observing the color, consistency, and amount of sputum helps in assessing the nature of the infection and guides further treatment. Sending the specimen to the lab is important but not the first action.
Family discharge teaching has been effective when the parent of a toddler diagnosed with Kawasaki disease (KD) states:
- A. The arthritis in her knees is permanent. She will need knee replacements.
- B. I will give her diphenhydramine (Benadryl) for her peeling palms and soles of her feet.
- C. I know she will be irritable for 2 months after her symptoms start.
- D. I will continue with high doses of Tylenol for her inflammation.
Correct Answer: C
Rationale: This statement indicates the parent understands that irritability may persist for about 2 months after symptom onset in KD.