Nokea
A wide splitting of S2 during expiration is auscultated in a 2-week-old infant.
- A. Atrial septal defect (ASD)
- B. Coarctation of the aorta (COA)
- C. Patent ductus arteriosis (PDA)
- D. Ventricular septal defect (VSD)
Correct Answer: A
Rationale: A wide splitting of S2 without becoming a single sound on expiration may indicate increased pulmonary flow, typical of atrial septal defect.
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A child with rheumatic fever is being admitted to the pediatric floor. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever?
- A. “Has your child complained of back pain?â€
- B. “Has your child complained of headaches?â€
- C. “Has your child had any nausea or vomiting?â€
- D. “Did your child have a sore throat or fever within the last 2 months?â€
Correct Answer: D
Rationale: A history of sore throat or fever within the last 2 months is significant as rheumatic fever often follows a streptococcal infection such as strep throat.
Recognised associations of Addison's disease include:
- A. Neurofibromatosis
- B. Phaeochromocytoma
- C. IDDM
- D. Nephrogenic diabetes insipidus
Correct Answer: C
Rationale: The correct answer is C because IDDM (insulin-dependent diabetes mellitus) is a recognized association of Addison's disease. The other options (a, b, d, e) are less commonly associated.
The following are suggestive of abnormal language development:
- A. Not localising sound at 4 months of age
- B. No response to human words at 6 weeks
- C. Not understanding 'no' at 18 months of age
- D. Does not move to music at 2 years of age
Correct Answer: C
Rationale: Failure to understand simple commands like 'no' by 18 months is a red flag for abnormal language development.
Causes of a loin mass and haematuria:
- A. Wilm's tumour
- B. Polycystic kidney disease
- C. Pyonephrosis
- D. Renal vein thrombosis
Correct Answer: A
Rationale: Wilm's tumour is a common cause of a loin mass and haematuria in children. Polycystic kidney disease and pyonephrosis can also present similarly.
Recognised diagnoses of tender scrotal swelling in infancy include:
- A. Inguinal hernia
- B. Epididymo-orchitis
- C. Breech delivery
- D. Torsion of testis
Correct Answer: D
Rationale: Torsion of the testis is a medical emergency and a common cause of tender scrotal swelling in infancy. Inguinal hernia and epididymo-orchitis are also possible but less urgent. Breech delivery is unrelated.