An 8-month-old infant has a hypercyanotic spell while blood is being drawn. What is the priority nursing action?
- A. Assess for neurologic defects
- B. Place the child in the knee-chest position
- C. Begin cardiopulmonary resuscitation
- D. Prepare family for imminent death
Correct Answer: B
Rationale: The first action is to place the infant in the knee-chest position. Blow-by oxygen may be indicated. Neurologic defects are unlikely. The child should be assessed for airway, breathing, and circulation. Often, calming the child and administering oxygen and morphine can alleviate the hypercyanotic spell.
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The following are associated with an increased risk of fetal abnormalities:
- A. Oligohydramnios
- B. A previous sibling with anencephaly
- C. Paternal diabetes
- D. Decreased a-fetoprotein level
Correct Answer: B
Rationale: A previous sibling with anencephaly increases the risk of fetal abnormalities, particularly neural tube defects, in subsequent pregnancies.
Toddler's diarrhoea is characterised by:
- A. Onset over 18 months
- B. Failure to thrive
- C. Excessive consumption of cow's milk
- D. Undigested food particles in the stool
Correct Answer: D
Rationale: The correct answer is D because undigested food particles in the stool are a hallmark of toddler's diarrhoea. The other options (a, b, c, e) are less specific.
Causes of a dilated renal pelvis in a foetal scan include:
- A. Normal variant
- B. Vesico-ureteric reflux
- C. Pelvi-ureteric junction obstruction
- D. Multicystic kidney
Correct Answer: A
Rationale: A dilated renal pelvis can be a normal variant in a foetal scan, often resolving spontaneously without intervention.
The following are strongly associated with Kawasaki disease EXCEPT
- A. duration of fever of >16 days
- B. first-degree heart block
- C. male gender
- D. age of <1 year
Correct Answer: B
Rationale: First-degree heart block is less commonly associated with Kawasaki disease compared to other factors.
Which of the following children are abnormal?
- A. 18-month-old who is able to put three blocks on top of each other and has a 2-word vocabulary
- B. 3-month-old who has just attained good head control, and is reaching for objects
- C. 5-year-old with difficulty in reading sentences from a book
- D. Bottom-shuffler who is still not walking at 16 months
Correct Answer: C
Rationale: A 5-year-old with difficulty reading sentences from a book may indicate a developmental or learning disorder, which is considered abnormal for that age.
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