Nokea
In a patient with painful joint swelling the following investigations are diagnostic:
- A. C-reactive protein
- B. Antinuclear antibodies
- C. Serum C3 (complement) levels
- D. Microscopic examination of synovial fluid
Correct Answer: D
Rationale: Microscopic examination of synovial fluid can reveal crystals, infection, or inflammation, providing a definitive diagnosis.
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The tricuspid valve is in closed position corresponding to which of the following curves of central venous pressure:
- A. a' wave
- B. x descent
- C. x' descent
- D. y descent
Correct Answer: B
Rationale: The tricuspid valve is closed during the x descent of the central venous pressure curve.
Regarding intussusception in childhood:
- A. Incidence is most common in children over 3 years of age
- B. Barium enema is the investigation of choice
- C. Patient commonly presents with constant abdominal pain
- D. It is associated with Henoch-Schoenlein purpura
Correct Answer: D
Rationale: Intussusception is associated with Henoch-Schoenlein purpura, a condition that can cause inflammation and bleeding in the small blood vessels.
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.
A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?
- A. Osmolarity
- B. Glucose
- C. Albumin
- D. Platelets
Correct Answer: B
Rationale: Hydrocortisone can affect blood glucose levels, making it important to monitor for hyperglycemia.
What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta?
- A. Blood pressure higher on the right side
- B. Blood pressure higher on the left side
- C. Blood pressure lower in the arms than in the legs
- D. Blood pressure lower in the legs than in the arms
Correct Answer: D
Rationale: The characteristic symptoms of coarctation of the aorta are a marked difference in blood pressure and pulses between the upper and lower extremities. Pressure is increased proximal to the defect and decreased distal to the coarctation.