Nokea
SVT in children differ from physiologic sinus tachycardia by all the following EXCEPT
- A. sudden onset and termination
- B. persistent ventricular rate of >180 bpm
- C. fixed RR interval on ECG
- D. evident change in heart rate with activity
Correct Answer: D
Rationale: Physiologic sinus tachycardia can show changes in heart rate with activity, unlike SVT which has a fixed rate.
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In normal neonates:
- A. Extracellular fluid volume exceeds intracellular fluid volume
- B. In a term baby, plasma calcium levels exceed that of the mother
- C. Clamping the umbilical cord after cessation of cord pulsations increases the blood volume by 20% in the baby
- D. There are two arteries and one vein in the umbilical cord
Correct Answer: A
Rationale: In neonates, extracellular fluid volume is greater than intracellular fluid volume, reflecting the transition from intrauterine to extrauterine life.
The following are causes of cyanosis in the presence of 60% oxygen:
- A. Haemoglobin concentration < 5 g%
- B. Methaemoglobinaemia
- C. Thalassaemia
- D. Right to left shunt
Correct Answer: D
Rationale: A right-to-left shunt can cause cyanosis even in the presence of high oxygen levels. Methaemoglobinaemia and severe anemia (Hb < 5 g%) can also cause cyanosis.
Which is not useful to test brainstem death in suspected cervical spine injury?
- A. Pupillary light reflex
- B. Doll's-eyes reflex
- C. Corneal reflex
- D. Oculo-vestibular reflex
Correct Answer: B
Rationale: Doll's-eyes reflex is not used in suspected cervical spine injury due to the risk of further injury.
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.
Increased fetal haemoglobin is seen in:
- A. Haemoglobin H disease
- B. β-thalassaemia major
- C. Fanconi's anaemia
- D. Pyruvate kinase deficiency
Correct Answer: B
Rationale: Increased fetal haemoglobin (HbF) is a compensatory mechanism in β-thalassaemia major to counteract the reduced production of adult haemoglobin (HbA).