Nokea
Increased fetal haemoglobin is seen in:
- A. Haemoglobin H disease
- B. β-thalassaemia major
- C. Fanconi's anaemia
- D. Pyruvate kinase deficiency
Correct Answer: B
Rationale: Increased fetal haemoglobin (HbF) is a compensatory mechanism in β-thalassaemia major to counteract the reduced production of adult haemoglobin (HbA).
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A nurse cares for a client who has an 80% blockage of the right coronary artery (RCA) and is scheduled for bypass surgery. Which intervention should the nurse be prepared to implement while this client waits for surgery?
- A. Administration of IV furosemide (Lasix)
- B. Initiation of an external pacemaker
- C. Assistance with endotracheal intubation
- D. Placement of central venous access
Correct Answer: B
Rationale: An 80% blockage of the RCA can lead to bradycardia or heart block. An external pacemaker may be needed to maintain adequate heart rate and cardiac output.
Nystagmus can be a presenting sign in:
- A. Partial albinism
- B. Retinopathy of prematurity
- C. Acute vestibulitis
- D. Medulloblastoma
Correct Answer: D
Rationale: Medulloblastoma, a type of brain tumor, can present with nystagmus due to its impact on the cerebellum and brainstem.
A male client with bilateral carpal tunnel syndrome reports to the nurse that the pain and tingling he is experiencing worsens at night. What client teaching should the nurse provide?
- A. Elevate the hands on two pillows at night
- B. Notify the healthcare provider as soon as possible
- C. Wear braces as both wrists during the night
- D. Apply cold compresses for 30 minutes before bedtime
Correct Answer: C
Rationale: Wearing wrist braces during the night helps prevent exacerbation of carpal tunnel syndrome symptoms.
Uncommon complications of severe falciparum malaria are:
- A. Stroke
- B. Anaemia
- C. Hepatitis
- D. Jaundice
Correct Answer: A
Rationale: The correct answer is A because stroke is an uncommon complication of severe falciparum malaria. The other options (b-e) are more common complications.
Diagnostic signs of child abuse are:
- A. Sub-hyaloid bleeding
- B. Spiral fracture of a long bone
- C. Lacerated tongue
- D. Posterior rib fractures
Correct Answer: D
Rationale: Posterior rib fractures are highly suggestive of child abuse, as they are often caused by forceful squeezing or shaking.