Nokea
Inability to do which of the following in a 20-month child is cause for concern?
- A. Speak in clear two to three word phrases
- B. Walk unaided
- C. Kick a ball
- D. Build a tower of 8 blocks
Correct Answer: B
Rationale: Inability to walk unaided by 20 months is a red flag for developmental delay. Other skills are more variable and less concerning if delayed.
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Characteristic indices in anaemia of chronic inflammation:
- A. Increased MCV
- B. Decreased ferritin
- C. Decreased transferrin
- D. Normal MCHC
Correct Answer: C
Rationale: Decreased transferrin: In anaemia of chronic inflammation, transferrin levels decrease due to inflammatory cytokines, which affect iron metabolism and its availability for erythropoiesis.
Congenital complete heart block
- A. Corrected TGA
- B. SLE mother's child
- C. Plonged QT
- D. MgSO4 therapy to mother
Correct Answer: B
Rationale: Congenital complete heart block is often associated with mothers who have systemic lupus erythematosus.
A male client who had abdominal surgery 5 days ago, and hospitalized because of a surgical wound infection, tells the nurse that he feels like his insides just spilled out when he coughed. What action should the nurse take first?
- A. Notify the healthcare provider
- B. Assure the client that such feelings occur with wound infections
- C. Visualize the abdominal incision
- D. Obtain sterile towels soaked in saline
Correct Answer: C
Rationale: Visualizing the incision helps determine if dehiscence or evisceration has occurred, which requires immediate intervention.
The following conditions are associated with hyperammonaemia:
- A. Reye syndrome
- B. Citrullinaemia
- C. Methylmalonic acidaemia
- D. Homocystinuria
Correct Answer: A
Rationale: Reye syndrome is associated with hyperammonaemia due to liver dysfunction and impaired urea cycle function, leading to ammonia accumulation.
A 6-month-old infant is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than _______ beats/min.
- A. 60
- B. 70
- C. 90 to 110
- D. 110 to 120
Correct Answer: C
Rationale: If the 1-minute apical pulse is below 90 to 110 beats/min, the digoxin should not be given to a 6-month-old. Sixty beats/min is the cut-off for holding the digoxin dose in an adult; 70 beats/min is the determining heart rate to hold a dose of digoxin for an older child; 110 to 120 beats/min is an acceptable heart rate to administer digoxin to a 6-month-old.