Nokea
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).
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Acute laryngotracheobronchitis in children:
- A. Needs to be treated by broad-spectrum antibiotics
- B. Humidified oxygen by tent needs to be administered in infancy
- C. Dexamethasone is known to shorten the duration of illness
- D. Adrenaline by nebuliser is absolutely contraindicated
Correct Answer: C
Rationale: Dexamethasone, a corticosteroid, is known to reduce inflammation and shorten the duration of illness in acute laryngotracheobronchitis (croup).
Abnormal coloration of the urine (in the absence of haematuria) may be due to:
- A. Consumption of beetroot
- B. Treatment with co-danthramer
- C. Phenylketonuria
- D. Acute intermittent porphyria
Correct Answer: A
Rationale: Beetroot can cause red urine. Co-danthramer, phenylketonuria, and porphyria can also cause abnormal urine color, but beetroot is a common cause.
The nurse is caring for a client with a lower left lobe pulmonary abscess. Which position should the nurse instruct the client to maintain?
- A. left lateral
- B. Supine, knees flexed
- C. Dorsal recumbent
- D. Knee-chest
Correct Answer: A
Rationale: The left lateral position promotes drainage of the abscess and improves ventilation.
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.
Progressive spinal muscular atrophy of infancy presents with:
- A. Severe generalised weakness
- B. Fasciculations in the tongue
- C. Loss of spinothalamic tract function
- D. Spontaneous fibrillation on electromyography
Correct Answer: A
Rationale: Progressive spinal muscular atrophy presents with severe weakness and tongue fasciculations. Spinothalamic tract function is preserved, and electromyography shows fibrillation.