Nokea
During play, a toddler with a history of tetralogy of Fallot (TOF) might assume which position?
- A. Sitting
- B. Supine
- C. Squatting
- D. Standing
Correct Answer: C
Rationale: Squatting naturally increases SVR by occluding venous return from the lower extremities, thereby increasing pulmonary blood flow.
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Regarding reflex anoxic seizures in children:
- A. ECG-rhythm strip is a must
- B. Asystole may be associated
- C. There is increased risk of epilepsy in adults
- D. Carbamazepine is the drug of choice
Correct Answer: B
Rationale: Reflex anoxic seizures in children are often triggered by a sudden noxious stimulus leading to transient asystole (cessation of heart activity). An ECG-rhythm strip is not always necessary there is no increased risk of epilepsy in adults and carbamazepine is not the drug of choice. Trauma can be a precipitating factor but the most relevant option is asystole.
A client with acute renal injury (AKI) who weighs 50 kg and has a potassium level of 6.7 mEq/L (6.7 mmol/l) is admitted to the hospital. Which prescribed medication should the nurse administer first?
- A. Sevelamer (RenaGel) one tablet PO.
- B. Epoetin alfa, recombinant (Epogen) 2,500 units SUBQ
- C. Sodium polystyrene (Kayexalate) 15 grams PO
- D. Calcium acetate (Phos-Lo) one tablet PO
Correct Answer: C
Rationale: Sodium polystyrene (Kayexalate) helps remove excess potassium, which is the priority concern in AKI with elevated potassium.
All the following are causes of heart failure in full-term neonate EXCEPT
- A. asphyxial
- B. coarctation of aorta
- C. hypoplastic left heart syndrome
- D. transposition of great arteries
Correct Answer: B
Rationale: Coarctation of the aorta may not immediately present with heart failure in full-term neonates.
Which among the following is not an admixture lesion?
- A. Transposition of great arteries
- B. Truncus arteriosus
- C. Total anomalous pulmonary venous connection
- D. Pulmonary atresia with intact ventricular septum
Correct Answer: D
Rationale: Pulmonary atresia with intact ventricular septum is not an admixture lesion.
An 18-months old infant weighing 10 kg develops an acute anaphylactic reaction with bronchospasm towards antibiotic injection. What is the most appropriate initial treatment?
- A. Inj. Hydrocortisone 100 mg IV stat
- B. Inj. Epinephrine 0.1 mg IV / IM stat
- C. Inj. Epinephrine 0.01 mg IV/IM stat
- D. Nebulization Salbutamol + oxygen
Correct Answer: C
Rationale: The most appropriate initial treatment for anaphylaxis in a child is intramuscular epinephrine at a dose of 0.01 mg/kg, which is 0.1 mg for a 10 kg child.