Nokea
An infant aged 16 months was referred for assessment of suspected mental retardation. Which of the following findings is/are outside the normal range?
- A. He does not scribble spontaneously with pencil on paper
- B. He does not walk alone
- C. Ma' and 'Dada' are the only recognisable words
- D. He is unable to build a tower of four cubes
Correct Answer: B
Rationale: Not walking alone by 16 months is a concern. Scribbling, limited vocabulary, and building towers are less concerning at this age.
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Which statement by the mother of a child with rheumatic fever (RF) shows she has a good understanding of the care of her child?
- A. I will apply heat to his swollen joints to promote circulation.
- B. I will have him do gentle stretching exercises to prevent contractures.
- C. I will give him the aspirin that is ordered for pain and inflammation.
- D. I will apply cold packs to his swollen joints to reduce pain.
Correct Answer: C
Rationale: Aspirin is the drug of choice for treating RF due to its anti-inflammatory and analgesic properties.
A child born with Trisomy 21 should be evaluated for which associated cardiac manifestation?
- A. Systemic hypertension
- B. Congenital heart defect
- C. Hyperlipidemia
- D. Cardiomyopathy
Correct Answer: B
Rationale: Children with Trisomy 21 (Down syndrome) have a high incidence of congenital heart defects, such as atrioventricular septal defects, and should be evaluated for these conditions.
The nurse is caring for an 8-year-old girl whose parents indicate she has developed spastic movements of her extremities and trunk, facial grimace, and speech disturbances. They state it seems worse when she is anxious and does not occur while sleeping. The nurse questions the parents about which recent illness?
- A. Kawasaki disease (KD)
- B. Strep throat
- C. Malignant hypertension
- D. Atrial fibrillation
Correct Answer: B
Rationale: Chorea (spastic movements, facial grimacing, and speech disturbances) can be a manifestation of rheumatic fever following streptococcal pharyngitis, with a higher incidence in females.
What is one reason why patients with CHD are more likely to have rejection post-transplant than those with cardiomyopathy?
- A. Sensitized recipients with panel reactive antibody (PRA)
- B. Absence of systemic disease
- C. History of good compliance
- D. None of the above
Correct Answer: A
Rationale: Patients with congenital heart disease (CHD) are often sensitized due to prior surgeries and blood transfusions, leading to a higher risk of rejection post-transplant.
Rocker bottom feet and polyvalvular dysplasia are characteristic of which of the following?
- A. Trisomy 19
- B. Trisomy 18
- C. Trisomy 13
- D. Trisomy 21
Correct Answer: B
Rationale: Rocker bottom feet and polyvalvular dysplasia are classic signs of trisomy 18 (Edwards syndrome), a condition that involves multiple congenital anomalies.