Nokea
Guillain-Barre syndrome (GBS) is excluded by:
- A. A normal CSF
- B. The presence of autonomic neuropathy
- C. Distinct sensory level
- D. Ophthalmoplegia
Correct Answer: C
Rationale: A distinct sensory level is not a feature of GBS, which typically presents with ascending symmetrical weakness and absent reflexes.
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A 4-year-old child has had fever, malaise, and vomiting and right-sided abdominal pain for 48 hours. The following are likely diagnoses:
- A. Acute pyelonephritis
- B. Shigella dysentery
- C. Ascaris lumbricoides infestation, if the child is living in the tropics
- D. Right sided tumour
Correct Answer: A
Rationale: Acute pyelonephritis is a common cause of fever, vomiting, and abdominal pain in children. Shigella dysentery typically causes diarrhea, and Ascaris infestation is rare in non-tropical regions. A right-sided tumour is unlikely without other signs.
What is the priority nursing action for a child who is post-operative following a tonsillectomy?
- A. Provide pain management.
- B. Encourage fluid intake.
- C. Monitor for signs of bleeding.
- D. Educate the child about proper oral hygiene.
Correct Answer: C
Rationale: The priority after a tonsillectomy is to monitor for bleeding, as this can be a serious complication.
Right to left shunts include:
- A. Fallot's tetralogy
- B. Tricuspid atresia
- C. Eisenmenger complex
- D. Ductus arteriosus in the fetus
Correct Answer: A
Rationale: Fallot's tetralogy is a congenital heart defect that includes a right-to-left shunt, allowing deoxygenated blood to bypass the lungs.
A child diagnosed with congestive heart failure (CHF) is receiving maintenance doses of digoxin and furosemide. She is rubbing her eyes when looking at the lights in the room, and her HR is 70 beats per minute. The nurse expects which laboratory finding?
- A. Hypokalemia
- B. Hypomagnesemia
- C. Hypocalcemia
- D. Hypophosphatemia
Correct Answer: A
Rationale: The child's eye rubbing may indicate seeing halos (a sign of digoxin toxicity), and the slow HR supports this. Furosemide can cause hypokalemia, increasing the risk for digoxin toxicity.
The nurse is caring for a child with Kawasaki disease (KD). A student nurse asks if there are medications to treat this disease. The nurse's response is:
- A. Immunoglobulin G and aspirin
- B. Immunoglobulin G and ACE inhibitors
- C. Immunoglobulin E and heparin
- D. Immunoglobulin E and ibuprofen
Correct Answer: A
Rationale: High-dose IV immunoglobulin G along with high-dose aspirin (salicylate therapy) is the current treatment for KD.