Nokea
A psychiatric referral is warranted in a preschool child with the following:
- A. Night terrors
- B. Separation anxiety
- C. Scared of ghosts
- D. Masturbation
Correct Answer: B
Rationale: Separation anxiety in a preschool child, especially if it is severe and persistent, may warrant a psychiatric referral to assess for anxiety disorders.
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A male client with bilateral carpal tunnel syndrome reports to the nurse that the pain and tingling he is experiencing worsens at night. What client teaching should the nurse provide?
- A. Elevate the hands on two pillows at night
- B. Notify the healthcare provider as soon as possible
- C. Wear braces as both wrists during the night
- D. Apply cold compresses for 30 minutes before bedtime
Correct Answer: C
Rationale: Wearing wrist braces during the night helps prevent exacerbation of carpal tunnel syndrome symptoms.
Distal renal tubular acidosis:
- A. Is characterised by hypokalaemia
- B. May be primary or secondary
- C. Presents with growth failure in infancy
- D. Urinary pH is usually < 5
Correct Answer: B
Rationale: Distal renal tubular acidosis (RTA) can be either primary (inherited) or secondary (acquired due to other conditions), affecting acid excretion in the distal tubule.
Nystagmus can be a presenting sign in:
- A. Partial albinism
- B. Retinopathy of prematurity
- C. Acute vestibulitis
- D. Medulloblastoma
Correct Answer: D
Rationale: Medulloblastoma, a type of brain tumor, can present with nystagmus due to its impact on the cerebellum and brainstem.
Features predisposing to NEC (necrotising enterocolitis) in the neonatal period include:
- A. Short fixation
- B. Asphyxia
- C. Umbilical artery catheter
- D. Maternal Crohn's disease
Correct Answer: B
Rationale: Asphyxia is a known risk factor for necrotizing enterocolitis (NEC) due to its effect on intestinal blood flow, leading to bowel ischemia and increased risk of bacterial translocation.
Epiphyseal changes are seen in:
- A. Non-accidental injury
- B. Rickets
- C. Chronic renal failure
- D. Lead poisoning
Correct Answer: B
Rationale: Rickets is characterized by epiphyseal changes due to defective mineralization of growing bones.