Nokea
Causes of pancytopenia and splenomegaly include:
- A. Low-grade non-Hodgkin's lymphoma
- B. Gaucher's disease
- C. Alcoholic cirrhosis
- D. BI2 deficiency
Correct Answer: B
Rationale: Gaucher's disease, a lysosomal storage disorder, can cause pancytopenia and splenomegaly due to bone marrow infiltration and hypersplenism.
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In congenital hypertrophic pyloric stenosis:
- A. Conjugated hyperbilirubinaemia may be seen
- B. Hypokalaemia is due to vomiting
- C. Blood pH is high and urinary pH is low
- D. First-born males are commonly affected
Correct Answer: B
Rationale: Hypokalaemia in congenital hypertrophic pyloric stenosis is typically due to the loss of potassium through vomiting.
An 8-month-old infant has a hypercyanotic spell while blood is being drawn. What is the priority nursing action?
- A. Assess for neurologic defects
- B. Place the child in the knee-chest position
- C. Begin cardiopulmonary resuscitation
- D. Prepare family for imminent death
Correct Answer: B
Rationale: The first action is to place the infant in the knee-chest position. Blow-by oxygen may be indicated. Neurologic defects are unlikely. The child should be assessed for airway, breathing, and circulation. Often, calming the child and administering oxygen and morphine can alleviate the hypercyanotic spell.
Paediatric HIV infection:
- A. Is similar to adult HIV infection except for the mode of transmission
- B. Antenatal screening of pregnant women is not of proven benefit
- C. Developmental delay is a recognised presentation
- D. In an infant, the diagnosis is established first before any management steps are undertaken
Correct Answer: C
Rationale: Developmental delay is a recognized presentation of paediatric HIV infection, reflecting the impact of the virus on the developing nervous system.
After a computer tomography (CT) scan with intravenous contrast medium, a client returns to the room complaining of shortness of breath and itching. Which intervention should the nurse implement?
- A. Call respiratory therapy to give a breathing treatment
- B. Send another nurse for an emergency tracheotomy set
- C. Prepare a dose of epinephrine (Adrenalin)
- D. Review the client's complete list of allergies
Correct Answer: C
Rationale: Shortness of breath and itching are signs of an allergic reaction to the contrast medium, and epinephrine is the first-line treatment for anaphylaxis.
Sodium valproate is used in all types of seizures except:
- A. Absences
- B. Infantile spasms
- C. Generalised clonic seizures
- D. Myoclonic type
Correct Answer: B
Rationale: Infantile spasms: Sodium valproate is not the first-line treatment for infantile spasms. Vigabatrin is preferred due to its effectiveness in this condition.