Nokea
Recognised diagnoses of tender scrotal swelling in infancy include:
- A. Inguinal hernia
- B. Epididymo-orchitis
- C. Breech delivery
- D. Torsion of testis
Correct Answer: D
Rationale: Torsion of the testis is a medical emergency and a common cause of tender scrotal swelling in infancy. Inguinal hernia and epididymo-orchitis are also possible but less urgent. Breech delivery is unrelated.
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Initial tests in a 2-year-old child with failure to thrive include:
- A. Thyroid function tests
- B. Sweat test
- C. Urine culture
- D. Colonoscopy
Correct Answer: B
Rationale: a sweat test is crucial for diagnosing cystic fibrosis, a common cause of failure to thrive in children. The other tests (a-d) are less specific and not typically first-line for this presentation.
Which patient could require feeding by gavage?
- A. Infant with congestive heart failure (CHF)
- B. Toddler with repair of transposition of the great vessels
- C. Toddler with Kawasaki disease (KD) in the acute phase
- D. School-age child with rheumatic fever (RF) and chorea
Correct Answer: B
Rationale: Feeding by gavage may be required if the child is unable to feed orally without increased cardiac demand, as might be seen after surgical repair of transposition of the great vessels.
Short stature due to growth hormone deficiency:
- A. Is characteristically manifest in infancy
- B. May be secondary to irradiation to the skull
- C. Can be part of congenital hypopituitarism
- D. Is easily corrected
Correct Answer: B
Rationale: Growth hormone deficiency can result from cranial irradiation, which may damage the pituitary gland and impair hormone production.
Prader Willi syndrome:
- A. Is caused by a maternal deletion of a part of chromosome 15
- B. Presents with macrosomia in infancy
- C. Developmental delay is common
- D. Behavioural problems are common
Correct Answer: C
Rationale: Developmental delay is a common feature of Prader Willi syndrome, along with other symptoms such as hypotonia and feeding difficulties in infancy.
A male client is recovering from an episode of urinary tract calculi. During discharge teaching, the client asks about the dietary restriction he should follow. In discussing fluid intake, the nurse should include which type of fluid limitation?
- A. Low-sodium soups.
- B. Over all fluid intake
- C. Tea and hot chocolate
- D. Citrus fruit juices
Correct Answer: C
Rationale: Tea and hot chocolate contain oxalates, which can contribute to the formation of calcium oxalate stones. Limiting these fluids helps prevent recurrence.