Nokea
Clinical manifestations of hypoplastic left-heart syndrome in the 1st 48 hr of life include
- A. always obvious color
- B. deep-blue skin
- C. bounding peripheral pulses
- D. occasional association with Turner syndrome
Correct Answer: C
Rationale: Bounding peripheral pulses are not typical in hypoplastic left-heart syndrome.
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An asymptomatic 45-year old male with newly diagnosed atrial fibrillation and normal echo, refused cardioversion while suggested. The next optimal management strategy for him is
- A. Sedate and cardiovert against patient wishes
- B. Aspirin
- C. Anticoagulation
- D. Rate control
Correct Answer: D
Rationale: Rate control is the optimal management strategy for asymptomatic atrial fibrillation when cardioversion is refused.
A client who had a biliopancreatic diversion procedure (BDP) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?
- A. Strong foul-smelling flatus
- B. Gastroccult positive emesis
- C. Complaint of poor night vision
- D. Loose bowel movements
Correct Answer: B
Rationale: Gastroccult positive emesis indicates gastrointestinal bleeding, which requires immediate intervention to prevent further complications.
A child aged 10 days has ambiguous genitalia:
- A. If a buccal smear is chromatin negative, there is a serious risk of an Addisonian crisis
- B. A raised urinary output of pregnanetriol would confirm a diagnosis of CAR
- C. The finding of the genotype 45 XO would reliably explain the anomaly
- D. If testicles were present in the 'labia', an acceptable explanation would be Klinefelter's syndrome
Correct Answer: B
Rationale: A raised urinary pregnanetriol indicates congenital adrenal hyperplasia (CAR). Chromatin-negative buccal smear suggests male genotype, and 45 XO is Turner syndrome, not related to ambiguous genitalia. Klinefelter's syndrome does not explain testicles in the labia.
The most common cause of bacterial meningitis in children under 5 years is:
- A. Neisseria meningitidis
- B. Haemophilus influenzae
- C. Streptococcus pneumoniae
- D. Listeria monocytogenes
Correct Answer: C
Rationale: Streptococcus pneumoniae is the leading cause of bacterial meningitis in children under 5 years, especially in those who are not immunized.
In Wilson's disease:
- A. There is an association with high caeruloplasmin levels
- B. Hepatic copper deposition is pathognomonic
- C. There is increased urinary excretion of copper
- D. There are copper deposits on the cornea
Correct Answer: D
Rationale: Copper deposits on the cornea (Kayser-Fleischer rings) are a hallmark of Wilson's disease, a genetic disorder leading to copper accumulation in tissues.