Nokea
Causes of a loin mass and haematuria:
- A. Wilm's tumour
- B. Polycystic kidney disease
- C. Pyonephrosis
- D. Renal vein thrombosis
Correct Answer: A
Rationale: Wilm's tumour is a common cause of a loin mass and haematuria in children. Polycystic kidney disease and pyonephrosis can also present similarly.
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One of the following is a characteristic physical finding in patients with an ASD
- A. a right precordial bulge
- B. a fixed splitting of the second heart sound
- C. a systolic ejection heart murmur
- D. a short, mild left mid-diastolic murmur
Correct Answer: B
Rationale: Fixed splitting of the second heart sound is a hallmark of an atrial septal defect.
What is the age-predicted maximum heart rate in a 60-year old man on beta blockers?
- A. 122
- B. 133
- C. 155
- D. 166
Correct Answer: A
Rationale: Beta blockers reduce the maximum heart rate. The age-predicted maximum heart rate for a 60-year-old on beta blockers is approximately 122 bpm.
Pulmonary hypertension is a complication of:
- A. ASD
- B. Eisenmenger syndrome
- C. Tricuspid atresia
- D. Tricuspid regurgitation
Correct Answer: B
Rationale: Eisenmenger syndrome is a well-known cause of pulmonary hypertension. The other options (a-d) can also lead to pulmonary hypertension but are less specific.
A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals vital signs of a regular heart rate of 230 beats per minute, respiratory rate of 30 per minute, BP of 84/52, and capillary refill time of 3 seconds. Which dysrhythmia does the nurse suspect in this child?
- A. Rapid atrial flutter
- B. Supraventricular tachycardia
- C. Sinus bradycardia
- D. Rapid atrial fibrillation
Correct Answer: B
Rationale: Supraventricular tachycardia is characterized by a very rapid heart rate, which can lead to decreased cardiac output and symptoms such as lethargy and difficulty waking, as seen in this toddler.
Recognised features of myotonic dystrophy include:
- A. Phenomenon of anticipation
- B. Muscle pain
- C. Diplopia
- D. Cardiomyopathy
Correct Answer: A
Rationale: The phenomenon of anticipation, where symptoms become more severe or appear at an earlier age as the disorder is passed through generations, is a recognized feature of myotonic dystrophy.