Nokea
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.
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All of the following are true regarding proximal renal tubular acidosis, except
- A. Growth failure in the first few years of life is a characteristic presentation
- B. Urine pH cannot be reduced to < 5.5
- C. It is usually a component of Fanconi syndrome
- D. Non-anion gap metabolic acidosis is common
Correct Answer: D
Rationale: Proximal renal tubular acidosis is associated with a normal anion gap metabolic acidosis, not a non-anion gap metabolic acidosis.
Acetazolamide:
- A. Is used in the management of renal tubular acidosis
- B. Causes hypokalaemia
- C. Is usually given intravenously
- D. Inhibits the action of carbonic anhydrase
Correct Answer: D
Rationale: Inhibits the action of carbonic anhydrase: Acetazolamide works by inhibiting carbonic anhydrase, reducing the reabsorption of bicarbonate in the kidneys and helping with conditions like glaucoma, metabolic alkalosis, and altitude sickness.
Dome and dart P wave in lead V1 in electrocardiogram is suggestive of which of the following?
- A. Dextrocardia
- B. Left atrial ectopic rhythm
- C. Biatrial enlargement
- D. Mitral stenosis
Correct Answer: C
Rationale: The dome and dart P wave morphology is characteristic of biatrial enlargement, often seen in conditions like mitral stenosis and atrial fibrillation.
Regarding fluid and electrolyte homeostasis in a child:
- A. Normal maintenance requirement in a child weighing 20 kg is 1.5 litre/day
- B. A fluid deficit of 50ml/kg produces a body weight loss of 10%
- C. Hypotension is a useful sign ,which indicates moderate dehydration
- D. Normal maintenance needs of sodium are 5-6mmol/kg/day
Correct Answer: B
Rationale: A fluid deficit of 50ml/kg producing a 10% body weight loss is a well-established clinical guideline for assessing dehydration in children. Hypotension is a late sign of severe dehydration, not moderate dehydration.
A client who took a camping vacation two weeks ago in a county with a tropical climate comes to the clinic describing vague symptoms and diarrhea for the past week. Which finding is most important for the nurse report to the healthcare provider?
- A. Weakness and fatigue
- B. Intestinal cramping
- C. Weight loss
- D. Jaundiced sclera
Correct Answer: D
Rationale: Jaundiced sclera indicates possible liver involvement, which could be due to a tropical disease such as hepatitis or leptospirosis.