Nokea
Progressive spinal muscular atrophy of infancy presents with:
- A. Severe generalised weakness
- B. Fasciculations in the tongue
- C. Loss of spinothalamic tract function
- D. Spontaneous fibrillation on electromyography
Correct Answer: A
Rationale: Progressive spinal muscular atrophy presents with severe weakness and tongue fasciculations. Spinothalamic tract function is preserved, and electromyography shows fibrillation.
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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.
All of the following are minor criteria in the latest Revised Jones criteria for rheumatic fever in moderate-high risk population except
- A. Monoarthalgia
- B. Fever with body temperature ≥ 38.5°C
- C. ESR 230 mm/hour
- D. Prolonged PR interval
Correct Answer: C
Rationale: ESR 230 mm/hour is not a minor criterion in the Revised Jones criteria for rheumatic fever.
The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin (Lanoxin). Which statement by the parent indicates a need for further instruction?
- A. “If my child vomits after the medication administration, I will repeat the dose.â€
- B. “I will not mix the medication with food.â€
- C. “I will take my child’s pulse before administering the medication.â€
- D. “If more than one dose is missed, I will call the provider.â€
Correct Answer: A
Rationale: Repeating the dose after vomiting can lead to digoxin toxicity, which is dangerous. The parent should be instructed to contact the healthcare provider if vomiting occurs after administration.
List FOUR other cardiac manifestations for Marfan’s syndrome, aside from aortopathy.
- A. Mitral valve prolapse/regurgitation
- B. Calcification of the mitral valve <40 years
- C. Dilation of pulmonary artery
- D. Dilation or dissection of ascending/descending aorta (<50 years old)
Correct Answer: A
Rationale: Marfan's syndrome may involve multiple cardiac complications including mitral valve prolapse and other structural heart abnormalities.
Regarding insulin administration in diabetics:
- A. Short-acting insulin reaches peak action in 4-6 hours after injection
- B. In a twice daily regimen involving Mixtard 30 or Humulin M3, the bedtime reading is an effect of the long-acting component
- C. A bedtime blood sugar level of 10 mmol/l is unacceptable
- D. Using the same site for injections is a common cause of increasing insulin dosage
Correct Answer: B
Rationale: The bedtime reading in a twice-daily regimen involving Mixtard 30 or Humulin M3 is influenced by the long-acting component, which has a prolonged effect.