Nokea
A nurse is caring for a child with Down syndrome. Which statement by the parent indicates the need for further teaching?
- A. I will make sure my child has regular hearing screenings.
- B. I will encourage my child to be active and participate in play.
- C. I should monitor my child's thyroid function regularly.
- D. I should avoid giving my child a multivitamin supplement.
Correct Answer: D
Rationale: Children with Down syndrome may benefit from a multivitamin supplement, especially if they are at risk for nutritional deficiencies.
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Diagnostic signs of child abuse are:
- A. Sub-hyaloid bleeding
- B. Spiral fracture of a long bone
- C. Lacerated tongue
- D. Posterior rib fractures
Correct Answer: D
Rationale: Posterior rib fractures are highly suggestive of child abuse, as they are often caused by forceful squeezing or shaking.
SVT in children differ from physiologic sinus tachycardia by all the following EXCEPT
- A. sudden onset and termination
- B. persistent ventricular rate of >180 bpm
- C. fixed RR interval on ECG
- D. evident change in heart rate with activity
Correct Answer: D
Rationale: Physiologic sinus tachycardia can show changes in heart rate with activity, unlike SVT which has a fixed rate.
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.
Recurrent headaches in childhood are seen with:
- A. Tension headaches
- B. Migraine
- C. Sinusitis
- D. Hypermetropia
Correct Answer: B
Rationale: The correct answer is B because migraine is a common cause of recurrent headaches in children. The other options (a, c, d, e) are less common or present differently.
The pH of urine:
- A. Is a useful indicator of the acid/base balance of blood
- B. Rises on a vegetarian diet
- C. Is determined by the concentration of ammonium
- D. Is lower than 5.5 in renal tubular acidosis
Correct Answer: A
Rationale: Urine pH reflects blood acid/base balance. A vegetarian diet typically raises urine pH, and renal tubular acidosis causes a higher pH, not lower.