Nokea
Nurse Alice is providing cardiopulmonary resuscitation (CPR) to a child, age 4. the nurse should:
- A. Compress the sternum with both hands at a depth of 1½ to 2†(4 to 5 cm)
- B. Deliver 12 breaths/minute
- C. Perform only two-person CPR
- D. Use the heel of one hand for sternal compressions
Correct Answer: D
Rationale: For a 4-year-old, the heel of one hand is appropriate for sternal compressions to achieve the correct depth and avoid injury.
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Possible causes of isosexual precocious puberty in a 6-year-old girl are:
- A. McCune-Albright syndrome
- B. Congenital adrenal hyperplasia (CAH)
- C. Ovarian tumour
- D. Hypothalamic hamartomas
Correct Answer: D
Rationale: Hypothalamic hamartomas can cause precocious puberty by secreting gonadotropin-releasing hormone (GnRH) prematurely.
Which of the following children are abnormal?
- A. 18-month-old who is able to put three blocks on top of each other and has a 2-word vocabulary
- B. 3-month-old who has just attained good head control, and is reaching for objects
- C. 5-year-old with difficulty in reading sentences from a book
- D. Bottom-shuffler who is still not walking at 16 months
Correct Answer: C
Rationale: A 5-year-old with difficulty reading sentences from a book may indicate a developmental or learning disorder, which is considered abnormal for that age.
The following drugs are contraindicated in renal failure:
- A. Nitrofurantoin
- B. Carbamazepine
- C. Salbutamol
- D. Metolazone
Correct Answer: A
Rationale: Nitrofurantoin is contraindicated in renal failure due to the risk of accumulation and subsequent toxicity, as the kidneys are unable to excrete the drug effectively.
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.
Early features of heart failure in infancy include:
- A. Bradycardia
- B. Oedema
- C. Tachypnoea
- D. Hepatomegaly
Correct Answer: C
Rationale: Tachypnoea is an early indicator of heart failure in infants, as the body tries to compensate for reduced oxygenation by increasing the respiratory rate.