Accepted maintenance treatment for chronic asthma includes the following:
- A. High-dose inhaled steroids and long-acting bronchodilators
- B. Montelucast
- C. Montelucast and inhaled steroids
- D. Long-acting ~2-agonists alone
Correct Answer: A
Rationale: The correct answer is A because high-dose inhaled steroids and long-acting bronchodilators are the mainstay of chronic asthma management. The other options (b-e) are less commonly used or not first-line.
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In systemic mastocytosis:
- A. Areas of depigmentation occur
- B. Intermittent flushing is seen
- C. IgE levels are high
- D. Is relieved by aspirin
Correct Answer: B
Rationale: Intermittent flushing is a recognized symptom of systemic mastocytosis due to the release of histamine and other chemicals from mast cells.
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.
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.
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).
During preoperative teaching for a male client scheduled for repair of an inguinal hernia, the client tells the nurse that he has had several surgeries and understands the need to perform coughing and deep breathing exercises after surgery. How should the nurse respond?
- A. Ask for a demonstration of these exercises
- B. Explain that coughing should be avoided
- C. Review the client’s previous surgical history
- D. Document the client's understanding of teaching
Correct Answer: A
Rationale: Asking for a demonstration ensures that the client understands the proper technique for coughing and deep breathing exercises.
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