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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The following favour a non-organic (psychological) cause of abdominal pain:
- A. Two-year history
- B. Family history of peptic ulcer
- C. Family history of migraine
- D. Absence from school
Correct Answer: A
Rationale: A long history of abdominal pain without organic findings suggests a psychological cause. Family history of peptic ulcer or migraine is less relevant.
A client who is newly diagnosed with emphysema is being prepared for discharge. Which instruction is best for the nurse to provide the client to assist them with dyspnea self-management?
- A. Allow additional time to complete physical activities to reduce oxygen demand
- B. Practice inhaling through the nose and exhaling slowly through pursed lips
- C. Use a humidifier to increase home air quality humidity between 30-50%
- D. Strengthen abdominal muscles by alternating leg raises during exhalation
Correct Answer: B
Rationale: Pursed-lip breathing helps improve oxygenation and reduce dyspnea in clients with emphysema.
Mechanisms of dyspnea in left heart disease include all, except
- A. PVH and decreased lung compliance
- B. Respiratory muscle fatigue
- C. Elevated LV End diastolic pressure leads to decreased antegrade coronary blood flow
- D. Reverse 'Bernheim' effect
Correct Answer: C
Rationale: Elevated LV end-diastolic pressure does not typically lead to decreased antegrade coronary blood flow.
In the most common type of CAR:
- A. There is deficient 11-hydroxylase
- B. Hypertension is a feature
- C. There is an associated gene defect
- D. Transmission is autosomal dominant
Correct Answer: B
Rationale: Hypertension is a feature of congenital adrenal hyperplasia (CAH) caused by deficiencies in enzymes involved in steroidogenesis, including 11-hydroxylase.
Which therapeutic management should the nurse expect to implement for a child with rheumatic fever?
- A. Administering penicillin
- B. Avoiding salicylates (aspirin)
- C. Imposing strict bed rest for 4 to 6 weeks
- D. Administering corticosteroids if chorea develops
Correct Answer: A
Rationale: The goal of medical management is the eradication of the hemolytic streptococci. Penicillin is the drug of choice. Salicylates can be used to control the inflammatory process, especially in the joints, and reduce the fever and discomfort. Bed rest is recommended for the acute febrile stage, but it does not need to be strict. The chorea is transient and will resolve without treatment.