Nokea
A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates?
- A. Seizure activity
- B. Hypoxia
- C. Sydenham’s chorea
- D. Decreasing level of consciousness
Correct Answer: C
Rationale: As the effects of rheumatic fever affect the central nervous system, the child may develop Sydenham’s chorea, manifested by involuntary, purposeless movements of the limbs.
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All of the following are minor criteria in the latest Revised Jones criteria for rheumatic fever in moderate-high risk population except
- A. Monoarthalgia
- B. Fever with body temperature ≥ 38.5°C
- C. ESR 230 mm/hour
- D. Prolonged PR interval
Correct Answer: C
Rationale: ESR 230 mm/hour is not a minor criterion in the Revised Jones criteria for rheumatic fever.
Causes of a discrete osteolytic bone lesion in a two-year-old include:
- A. Rickets
- B. Non-accidental injury
- C. Eosinophilic granuloma
- D. Acute lymphoblastic leukaemia
Correct Answer: C
Rationale: Eosinophilic granuloma is a benign bone lesion that can present with osteolytic lesions, typically seen in children as part of Langerhans cell histiocytosis.
The MOST common cause of pulmonary hypertension in pediatric patients is
- A. idiopathic pulmonary hypertension
- B. pulmonary venoocclusive disease
- C. left-sided valvular heart disease
- D. chronic obstructive pulmonary disease
Correct Answer: A
Rationale: Idiopathic pulmonary hypertension is a rare but recognized cause of pulmonary hypertension in children.
The most common cause for testicular pain in boys in 2-10 years of age is
- A. Testicular torsion
- B. Torsion of appendix testis
- C. Epididymitis
- D. Congenital varicocele
Correct Answer: B
Rationale: Torsion of the appendix testis is the most common cause of testicular pain in boys aged 2-10 years, as it involves the twisting of a small vestigial remnant.
When caring for an 11-month-old infant with dehydration and metabolic acidosis, the nurse expects to see which of the following?
- A. A reduced white blood cell count
- B. A decreased platelet count
- C. Shallow respirations
- D. Tachypnea
Correct Answer: D
Rationale: Tachypnea is a compensatory mechanism in metabolic acidosis to help expel excess carbon dioxide and correct the acid-base imbalance.