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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Causes of hypertension in a child include:
- A. Long-standing vesico-ureteric reflux
- B. Cushing's syndrome
- C. Addison's disease
- D. Turner's syndrome
Correct Answer: B
Rationale: Cushing's syndrome, characterized by excessive cortisol levels, is a known cause of secondary hypertension in children.
A diagnosis of primary pulmonary hypertension of the newborn can be made if:
- A. Oxygen saturation in the hand is 80% and in the foot 67%
- B. A tachypnoeic baby has a saturation of 60%
- C. A baby with history of being covered in thick meconium at birth has PaO2 of 4kPa
- D. A septic baby is hypoxic in 100% oxygen
Correct Answer: A
Rationale: A significant difference in oxygen saturation between the upper and lower extremities (e.g., hand 80%, foot 67%) is indicative of persistent pulmonary hypertension of the newborn (PPHN).
Among the following Group A beta hemolytic streptococcus has the highest resistance to
- A. Cephalexin
- B. Clindamycin
- C. Erythromycin
- D. Doxycycline
Correct Answer: C
Rationale: Group A beta hemolytic streptococcus has shown the highest resistance to erythromycin.
In normal neonates:
- A. Extracellular fluid volume exceeds intracellular fluid volume
- B. In a term baby, plasma calcium levels exceed that of the mother
- C. Clamping the umbilical cord after cessation of cord pulsations increases the blood volume by 20% in the baby
- D. There are two arteries and one vein in the umbilical cord
Correct Answer: A
Rationale: In neonates, extracellular fluid volume is greater than intracellular fluid volume, reflecting the transition from intrauterine to extrauterine life.
Regarding idiopathic thrombocytopenic purpura (ITP):
- A. The more severe the disease
- B. the faster is the recovery to therapy
- C. Alloimmunisation occurs due to fetomaternal incompatibility
- D. Splenomegaly is a recognised feature
Correct Answer: C
Rationale: ITP is characterized by low platelet counts due to immune-mediated destruction. Splenomegaly is a recognized feature but the other options are incorrect. Recovery is not necessarily faster with more severe disease alloimmunisation is not a feature of ITP and not all children with platelet counts below 50 000 require hospitalization. IV immunoglobulin is not indicated in all cases.