Nokea
Appropriate initial management steps in an acute anaphylactic reaction to a blood transfusion include:
- A. Nebulised steroids
- B. Oxygen
- C. Intravenous hydrocortisone
- D. Intravenous anti-H2 agent
Correct Answer: B
Rationale: Oxygen is a critical initial management step in anaphylaxis to ensure adequate oxygenation during the acute phase.
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All of the following are true regarding attention deficit hyperactivity disorder (ADHD), except
- A. Dopamine transporter gene (DAT1) and dopamine 4 receptor gene (DRD4) are implicated in the diagnosis
- B. Impaired fine motor movement and poor coordination are 'soft' but specific signs of ADHD
- C. Developmentally inappropriate behavior must commence before 7 years of age and present for at least 6 months
- D. Maternal lead exposure is associated with ADHD
Correct Answer: B
Rationale: Impaired fine motor movement and poor coordination are not specific signs of ADHD; they are nonspecific and can occur in other conditions.
Causes for hypertension in childhood
- A. PDA
- B. Hemolytic uremic syndrome
- C. Guillain-Barre syndrome
- D. Lead poisoning
Correct Answer: A
Rationale: Patent ductus arteriosus (PDA) is a common cause of hypertension in childhood.
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.
Recognised causes of delayed speech include:
- A. Hypothyroidism
- B. PKU
- C. Cystinuria
- D. Twins
Correct Answer: A
Rationale: Hypothyroidism is a known cause of delayed speech. PKU and deafness can also cause speech delays, but cystinuria is not associated with speech delay.
The following are true of umbilical hernia:
- A. It is more common in Caucasian than Blacks
- B. It is commonly associated with hypothyroidism
- C. It must be operated on by two years of age
- D. It becomes obstructed in 2% of cases
Correct Answer: D
Rationale: Umbilical hernias can become obstructed in about 2% of cases. They are more common in Blacks and are not typically associated with hypothyroidism.