Nokea
A child is undergoing remission induction therapy to treat leukemia. Allopurinol is included in the regimen. The main reason for administering allopurinol as part of the client’s chemotherapy regimen is to:
- A. Prevent metabolic breakdown of xanthine to uric acid
- B. Prevent uric acid from precipitating in the ureters
- C. Enhance the production of uric acid to ensure adequate excretion of urine
- D. Ensure that the chemotherapy doesn’t adversely affect the bone marrow
Correct Answer: A
Rationale: Allopurinol prevents the breakdown of xanthine to uric acid, reducing the risk of uric acid nephropathy during chemotherapy-induced tumor lysis.
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True statements about the use of the new Child Health Foundation growth charts include:
- A. Immediate referral is advised if the height of a child is on the second centile
- B. The midparental height of a child, whose parents are 176 and 160 cm tall, is 175 cm
- C. They can be used for all children including those with Down's syndrome
- D. The target centile range for a girl is midparental height ± 10 cm
Correct Answer: C
Rationale: The growth charts are designed to be inclusive and can be used for children with Down's syndrome, among others.
All of the following are true regarding intussusception in children, except
- A. It is more common in boys than girls
- B. Adeno virus C has been implicated
- C. Urgent barium meal follow-through is the investigation of choice
- D. Postoperative intussusception is commonly ileoileal
Correct Answer: C
Rationale: Urgent barium meal follow-through is not the investigation of choice for intussusception; ultrasound is preferred for diagnosis.
In scabies:
- A. Itching is due to sensitisation by the mite
- B. Vesicles may be seen in children
- C. The organism is easily demonstrated
- D. Spread can occur through clothes and bedding
Correct Answer: A
Rationale: Itching in scabies is due to an allergic reaction to the mites and their products, leading to sensitization.
For the child with hypoplastic left heart syndrome, which medication may be given to keep the patent ductus arteriosus (PDA) open until surgery can be done?
- A. Prostaglandin E
- B. Indomethicin
- C. Ibuprofen
- D. Digoxin
Correct Answer: A
Rationale: Prostaglandin E is used to keep the PDA open in infants with hypoplastic left heart syndrome, allowing for adequate blood flow until surgical intervention can be performed.
A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur. What diagnostic test does the nurse anticipate?
- A. Barium swallow
- B. Chest x-ray
- C. Electrocardiogram
- D. Echocardiogram
Correct Answer: D
Rationale: Echocardiography is a noninvasive procedure that localizes murmurs and determines if the heart is structurally normal.