In childhood, hypokalaemic alkalosis is a recognised finding:
- A. In a baby given feeds that are too concentrated
- B. In congenital pyloric stenosis
- C. In cystic fibrosis
- D. Following urinary diversion
Correct Answer: B
Rationale: Hypokalaemic alkalosis is a hallmark of congenital pyloric stenosis due to vomiting. It is not typically associated with concentrated feeds, cystic fibrosis, or urinary diversion.
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During a paracentesis, two liters of fluid are removed from the abdomen of a client with ascites. A drainage bag is placed, and 50 ml of clear, straw-colored fluid drains within the first hour. What action should the nurse implement?
- A. Palpate for abdominal distention
- B. Send fluid to the lab for analysis
- C. Continue to monitor the fluid output
- D. Clamp the drainage tube for 5 minutes
Correct Answer: C
Rationale: Monitoring fluid output is essential to assess for complications such as reaccumulation of fluid or bleeding.
A child of 36 months would be expected to:
- A. Build a tower of 5 cubes
- B. Repeat back 5 digits
- C. Draw a man with a head and body
- D. Demonstrate symbolic play
Correct Answer: D
Rationale: At 36 months, a child is expected to demonstrate symbolic play. Building a tower of 5 cubes and drawing a man with a head and body are also typical milestones.
All the following are causes of chronic pulmonary venous hypertension EXCEPT
- A. congenital mitral stenosis
- B. total anomalous pulmonary venous return with obstruction
- C. peripheral pulmonary stenosis
- D. cor triatriatum
Correct Answer: C
Rationale: Peripheral pulmonary stenosis does not directly cause chronic pulmonary venous hypertension.
The nurse is teaching parents about signs of digoxin (Lanoxin) toxicity. Which is a common sign of digoxin toxicity?
- A. Seizures
- B. Vomiting
- C. Bradypnea
- D. Tachycardia
Correct Answer: B
Rationale: Vomiting is a common sign of digoxin toxicity. Seizures are not associated with digoxin toxicity. The child will have a slower heart rate, not respiratory rate. The heart rate will be slower, not faster.
The following statements are true about screening:
- A. The sensitivity of a screening test is the extent of picking up true negatives
- B. Positive predictive value is dependent on the population being screened
- C. A good screening test is always inexpensive
- D. Screening for Duchenne muscular dystrophy is not practised, mainly because of the extent of false positives in the test
Correct Answer: B
Rationale: The positive predictive value of a screening test is influenced by the prevalence of the condition in the population being screened.