Nokea
An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?
- A. I get short of breath when I climb stairs.
- B. I see halos floating around my head.
- C. I have trouble remembering things.
- D. I have lost weight over the past month.
Correct Answer: A
Rationale: Shortness of breath, especially during exertion, is a classic symptom of heart failure due to the heart's inability to pump blood effectively.
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In autism:
- A. Social interaction is normal
- B. Dopamine levels are reduced
- C. Genetic factors may play a role in aetiology
- D. Methylphenidate is used with benefit
Correct Answer: C
Rationale: Genetic factors may play a role in aetiology: Autism spectrum disorder (ASD) has a strong genetic component, with numerous genes contributing to its development, although environmental factors may also play a role.
The following are true statements:
- A. Tissue plasminogen activator is derived from endothelium
- B. Heparin acts through antithrombin III
- C. Protein C deficiency is autosomal recessive transmitted
- D. Protein C is vitamin K dependent
Correct Answer: B
Rationale: Heparin acts through antithrombin III: Heparin enhances the activity of antithrombin III, which inhibits thrombin and other clotting factors, helping prevent clot formation.
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.
A male client who had abdominal surgery 5 days ago, and hospitalized because of a surgical wound infection, tells the nurse that he feels like his insides just spilled out when he coughed. What action should the nurse take first?
- A. Notify the healthcare provider
- B. Assure the client that such feelings occur with wound infections
- C. Visualize the abdominal incision
- D. Obtain sterile towels soaked in saline
Correct Answer: C
Rationale: Visualizing the incision helps determine if dehiscence or evisceration has occurred, which requires immediate intervention.
Arrhythmia in Children
- A. Re entry Tachycardia is the commonest
- B. Adenosine decreases the force of cardiac contractility
- C. SVT can cause hydrops foetalis
- D. Valsalva maneuver can restore sinus rhythm
Correct Answer: A
Rationale: Re-entry tachycardia is the most common type of arrhythmia in children.