Nokea
Cristina, a mother of a 4-year-old child tells the nurse that her child is a very poor eater. What’s the nurse’s best recommendation for helping the mother increase her child’s nutritional intake?
- A. Allow the child to feed herself
- B. Use specially designed dishes for children – for example, a plate with the child’s favorite cartoon character
- C. Only serve the child’s favorite foods
- D. Allow the child to eat at a small table and chair by herself
Correct Answer: A
Rationale: Allowing the child to feed herself promotes independence and may increase interest in eating.
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The following factors trigger renin secretion:
- A. Hyponatremia
- B. ACTH
- C. Hypovolemia
- D. ADH
Correct Answer: C
Rationale: Hypovolemia: Renin is secreted by the kidneys in response to low blood volume (hypovolemia), initiating the renin-angiotensin-aldosterone system to conserve sodium and increase blood pressure.
Peak expiratory flow rate:
- A. Is a sensitive parameter to assess improvement to therapy in acute bronchial asthma
- B. Measures small airway resistance
- C. Is more related to height rather than age
- D. Less than 50% of normal is an indication for aminophylline therapy in acute asthma
Correct Answer: A
Rationale: Peak expiratory flow rate is a useful tool to monitor response to asthma therapy, particularly in acute exacerbations.
While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has:
- A. Pulmonary hypertension
- B. Patent ductus arteriosus (PDA)
- C. Ventricular septal defect (VSD)
- D. Bronchopulmonary dysplasia
Correct Answer: B
Rationale: A machine-like murmur is the hallmark of a PDA.
Down syndrome and VSD
- A. Doesn't close spontaneously as in children without downs
- B. Inaudible murmur is a characteristic feature / Murmur is not audible
- C. Pulmonary Hypertension is a late complication
- D. If no murmur, condition need not be investigated
Correct Answer: C
Rationale: Pulmonary hypertension is a known late complication in Down syndrome with VSD.
All of the following are true regarding intussusception in children, except
- A. It is more common in boys than girls
- B. Adeno virus C has been implicated
- C. Urgent barium meal follow-through is the investigation of choice
- D. Postoperative intussusception is commonly ileoileal
Correct Answer: C
Rationale: Urgent barium meal follow-through is not the investigation of choice for intussusception; ultrasound is preferred for diagnosis.