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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The following are true about water excretion:
- A. It is influenced by the proximal tubule
- B. It is influenced by vasopressin
- C. It depends on erythropoietin
- D. It is influenced by the ascending limb of the loop of Henle
Correct Answer: B
Rationale: It is influenced by vasopressin: Vasopressin (ADH) regulates water reabsorption in the kidneys, primarily by acting on the collecting ducts, enhancing water retention in response to dehydration.
Nurse Mariane is caring for an infant with spina bifida. Which technique is most important in recognizing possible hydrocephalus?
- A. Measuring head circumference
- B. Obtaining skull X-ray
- C. Performing a lumbar puncture
- D. Magnetic resonance imaging (MRI)
Correct Answer: A
Rationale: Measuring head circumference is a non-invasive way to monitor for hydrocephalus, a common complication of spina bifida.
Three days after a female client with multiple sclerosis (MS) is admitted to the hospital with a severe urinary tract infection, she reports experiencing double vision. Which intervention should the nurse implement?
- A. Patch one eye and then the other every few hours
- B. Encourage bedrest until the diplopia is resolved
- C. Instruct the client to limit intake of oral fluids
- D. Administer artificial tear drops to both eyes
Correct Answer: A
Rationale: Patching each eye helps alleviate double vision caused by MS-related vision impairment.
During a well baby examination of a 6-week-old infant, poor weight gain, acrocyanosis of the hands and feet, and a respiratory rate of 60 breaths per minute are noted. Oxygen saturation on room air is 93%. What is the correct action?
- A. Follow-up in 1 week to assess the infant's weight.
- B. Order a chest radiograph and an electrocardiogram.
- C. Reassure the parents that the exam is within normal limits.
- D. Refer the infant to a pediatric cardiologist.
Correct Answer: D
Rationale: Infants with oxygen saturation less than 95% and those with poor feeding should be referred emergently to a cardiologist.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely “asleep†during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: D
Rationale: The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.