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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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A child with rheumatic fever is being admitted to the pediatric floor. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever?
- A. “Has your child complained of back pain?â€
- B. “Has your child complained of headaches?â€
- C. “Has your child had any nausea or vomiting?â€
- D. “Did your child have a sore throat or fever within the last 2 months?â€
Correct Answer: D
Rationale: A history of sore throat or fever within the last 2 months is significant as rheumatic fever often follows a streptococcal infection such as strep throat.
In ventricular arrythmia:
- A. PR interval is prolonged
- B. Common in thyrotoxicosis
- C. Synchronised DC shock is the treatment of choice
- D. IV adenosine treatment is effective
Correct Answer: C
Rationale: Synchronised DC shock is the treatment of choice: In cases of life-threatening ventricular arrhythmias, such as ventricular fibrillation or pulseless ventricular tachycardia, synchronized direct current shock (DC shock) is the recommended treatment.
All are true about TAPSE (Tricuspid Annular Plane Systolic Excursion), except
- A. Normal TAPSE is >17 mm
- B. Reliable measure of RV systolic function
- C. Can be measured using either M-mode or 2D echo
- D. TAPSE is measured at septal aspect of tricuspid annulus
Correct Answer: D
Rationale: TAPSE is measured at the lateral aspect of the tricuspid annulus, not the septal aspect.
What should the school nurse recommend when encouraging a heart-healthy diet for a child with high cholesterol?
- A. A fat intake reduction of 5-10% of total calories
- B. A fat intake reduction of 10-15% of total calories
- C. A fat intake reduction of 15-20% of total calories
- D. A fat intake reduction of 25-35% of total calories
Correct Answer: D
Rationale: For a child with increased cholesterol, a fat reduction of 25-35% of total calories with less than 75 saturated fat and less than 200 mg of cholesterol per day is advised.
Causes of hypogonadotropic hypogonadism are:
- A. Kallman's syndrome
- B. Testicular atrophy
- C. Klinefelter's syndrome
- D. Hypothalamic tumour
Correct Answer: A
Rationale: The correct answer is A because Kallman's syndrome is a well-known cause of hypogonadotropic hypogonadism. The other options (b-e) are either causes of hypergonadotropic hypogonadism or unrelated conditions.