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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Pulmonary hypotension in a neonate associate with
- A. Diaphragmatic hernia
- B. Oxygen therapy
- C. Meconium aspiration
- D. Pneumothrax
Correct Answer: A
Rationale: Diaphragmatic hernia can lead to decreased lung expansion and pulmonary hypotension.
A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?
- A. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg
- B. The respiratory rate decreased from 25 breaths/min to 14 breaths/min
- C. Pulse decreased from 100 beats/min to 80 beats/min
- D. Oxygen saturation increased from 88% to 96%
Correct Answer: D
Rationale: Beta blockers reduce heart rate and blood pressure. A decrease in pulse rate from 100 beats/min to 80 beats/min is consistent with the expected pharmacological effect of a beta blocker.
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.
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.
Elevated levels of CPK are seen in:
- A. Duchenne muscular dystrophy
- B. Dermatomyositis
- C. Spinal muscular atrophy
- D. Malignant hyperthermia
Correct Answer: A
Rationale: Duchenne muscular dystrophy: Elevated creatine phosphokinase (CPK) levels are a hallmark of Duchenne muscular dystrophy due to muscle damage and degeneration.