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A heart transplant may be indicated for a child with severe heart failure and:
- A. Patent ductus arteriosus (PDA)
- B. Ventricular septal defect (VSD)
- C. Hypoplastic left heart syndrome
- D. Pulmonic stenosis (PS)
Correct Answer: C
Rationale: Hypoplastic left heart syndrome is treated by procedures such as the Norwood procedure or heart transplant.
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Benign Rolandic seizures:
- A. Usually occurs at night
- B. Are difficult to control with drugs
- C. Centrotemporal spikes in EEG are a recognised feature
- D. Are more common than petit mal
Correct Answer: C
Rationale: Centrotemporal spikes on EEG are a hallmark feature of benign Rolandic epilepsy, a common childhood epilepsy syndrome.
The nurse is caring for a child who has undergone a cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurse's first action is to:
- A. Call the interventional cardiologist
- B. Notify the cardiac catheterization laboratory that the child will be returning
- C. Apply a bulky pressure dressing over the present dressing
- D. Apply direct pressure 1 inch above the puncture site
Correct Answer: D
Rationale: Direct pressure above the puncture site helps control bleeding by localizing pressure over the vessel.
Possible causes of isosexual precocious puberty in a 6-year-old girl are:
- A. McCune-Albright syndrome
- B. Congenital adrenal hyperplasia (CAH)
- C. Ovarian tumour
- D. Hypothalamic hamartomas
Correct Answer: D
Rationale: Hypothalamic hamartomas can cause precocious puberty by secreting gonadotropin-releasing hormone (GnRH) prematurely.
Appropriate investigations in the emergency management of a 4-year-old presenting in a coma:
- A. Serum magnesium level
- B. Throat swabs
- C. Arterial blood gas
- D. CT scan
Correct Answer: C
Rationale: Arterial blood gas analysis is crucial in the emergency management of a comatose child to assess oxygenation, ventilation, and acid-base status.
Causes of pancytopenia and splenomegaly include:
- A. Low-grade non-Hodgkin's lymphoma
- B. Gaucher's disease
- C. Alcoholic cirrhosis
- D. BI2 deficiency
Correct Answer: B
Rationale: Gaucher's disease, a lysosomal storage disorder, can cause pancytopenia and splenomegaly due to bone marrow infiltration and hypersplenism.