Nokea
Common reasons for doing a BMT in children are:
- A. SCID (severe combined immunodeficiency)
- B. Acute lymphoblastic leukemia
- C. CML
- D. Gaucher's disease
Correct Answer: A
Rationale: The correct answer is A because SCID is a primary indication for bone marrow transplant (BMT) in children. The other options (b-e) are also indications but less common.
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The nurse is providing discharge instructions to a client who is receiving prednisone (Deltasone) 5 mg PO daily for a rash due to contact with poison ivy. Which symptom should the nurse tell the client to report to the healthcare provider?
- A. Rapid weight gain
- B. Increased energy levels.
- C. Frequent headaches.
- D. Dry mouth.
Correct Answer: A
Rationale: Rapid weight gain may indicate fluid retention, a side effect of prednisone that requires medical evaluation.
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.
Clubbing is found in:
- A. Crohn's disease
- B. Bronchiectasis
- C. Rheumatic fever
- D. Infective endocarditis
Correct Answer: B
Rationale: Clubbing is commonly associated with chronic respiratory conditions such as bronchiectasis, due to chronic hypoxia and inflammation.
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.
Of the following, the MOST common clinical sign of coarctation of the aorta in older children is
- A. cardiac enlargement
- B. notching of the inferior border of the ribs
- C. a systolic ejection click or thrill in the suprasternal notch
- D. differential blood pressure: arms > legs
Correct Answer: B
Rationale: Notching of the ribs due to collateral circulation is a classic sign of coarctation of the aorta.