Nokea
In congenital hypertrophic pyloric stenosis:
- A. Conjugated hyperbilirubinaemia may be seen
- B. Hypokalaemia is due to vomiting
- C. Blood pH is high and urinary pH is low
- D. First-born males are commonly affected
Correct Answer: B
Rationale: Hypokalaemia in congenital hypertrophic pyloric stenosis is typically due to the loss of potassium through vomiting.
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These causes often cause secretory diarrhoea except:
- A. Lactose intolerance
- B. E. coli infection
- C. Congenital chloridorrhoea
- D. Blind loop syndrome
Correct Answer: A
Rationale: The correct answer is A because lactose intolerance causes osmotic diarrhoea, not secretory diarrhoea. The other options (b-e) are causes of secretory diarrhoea.
Which of the following has the highest proportion of etiology of congenital malformations?
- A. Maternal infections
- B. Maternal illness
- C. Environmental agents
- D. Monogenic inheritance
Correct Answer: D
Rationale: Monogenic inheritance accounts for the highest proportion of congenital malformations.
A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever?
- A. Subcutaneous nodules and fever
- B. Painful, tender joints, and carditis
- C. Erythema marginatum and arthralgia
- D. Chorea and elevated sedimentation rate
Correct Answer: B
Rationale: The presence of two major Jones criteria would indicate a high probability of rheumatic fever.
An 8-month-old infant has a hypercyanotic spell while blood is being drawn. What is the priority nursing action?
- A. Assess for neurologic defects
- B. Place the child in the knee-chest position
- C. Begin cardiopulmonary resuscitation
- D. Prepare family for imminent death
Correct Answer: B
Rationale: The first action is to place the infant in the knee-chest position. Blow-by oxygen may be indicated. Neurologic defects are unlikely. The child should be assessed for airway, breathing, and circulation. Often, calming the child and administering oxygen and morphine can alleviate the hypercyanotic spell.
The following are true statements:
- A. Tissue plasminogen activator is derived from endothelium
- B. Heparin acts through antithrombin III
- C. Protein C deficiency is autosomal recessive transmitted
- D. Protein C is vitamin K dependent
Correct Answer: B
Rationale: Heparin acts through antithrombin III: Heparin enhances the activity of antithrombin III, which inhibits thrombin and other clotting factors, helping prevent clot formation.