Nokea
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.
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In neonates with anomalous total pulmonary venous return and obstruction, the chest x-ray demonstrates
- A. heart enlarged
- B. prominent pulmonary artery
- C. prominent right ventricle
- D. prominent subaortic stenosis
Correct Answer: D
Rationale: Prominent subaortic stenosis is not typically seen in TAPVR.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely “asleep†during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: D
Rationale: The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.
Causes of a discrete osteolytic bone lesion in a two-year-old include:
- A. Rickets
- B. Non-accidental injury
- C. Eosinophilic granuloma
- D. Acute lymphoblastic leukaemia
Correct Answer: C
Rationale: Eosinophilic granuloma is a benign bone lesion that can present with osteolytic lesions, typically seen in children as part of Langerhans cell histiocytosis.
The nurse is planning a hypertension-prevention program. What should be the main focus of the nurse when presenting information?
- A. Pharmacological treatment
- B. Surgical interventions available
- C. Patient education
- D. Reduction of aerobic exercise
Correct Answer: C
Rationale: The main focus of a hypertension-prevention program is patient education.
Which vaccines must be delayed for 11 months after the administration of gamma globulin? (Select all that apply.)
- A. Diphtheria, tetanus, and pertussis
- B. Hepatitis B
- C. Inactivated polio virus
- D. Measles, mumps, and rubella
Correct Answer: D
Rationale: Live virus vaccines (MMR and Varicella) should be delayed for 11 months after gamma globulin infusion because the passive antibodies can interfere with vaccine efficacy.