Nokea
The differential in a 5-year old with a 2-week history of painful joints is all the following except:
- A. Viral polyarthritis
- B. Rheumatoid arthritis
- C. Lyme disease
- D. Rheumatic fever
Correct Answer: B
Rationale: rheumatoid arthritis is rare in a 5-year-old with a 2-week history of joint pain. The other options (a-d) are more likely differentials.
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Toddler's diarrhoea is characterised by:
- A. Onset over 18 months
- B. Failure to thrive
- C. Excessive consumption of cow's milk
- D. Undigested food particles in the stool
Correct Answer: D
Rationale: The correct answer is D because undigested food particles in the stool are a hallmark of toddler's diarrhoea. The other options (a, b, c, e) are less specific.
Rare causes of bloody diarrhoea include:
- A. Campylobacter infection
- B. Peutz-Jegher's syndrome
- C. Enterotoxigenic E. coli
- D. Crohn's disease
Correct Answer: B
Rationale: Rare causes of bloody diarrhoea include conditions like Peutz-Jegher's syndrome which is a genetic disorder causing polyps in the gastrointestinal tract. Campylobacter Shigella and Enterotoxigenic E. coli are common causes of infectious diarrhoea while Crohn's disease is a chronic inflammatory condition.
Regarding resuscitation of a three-year old with asystole:
- A. Hypoxia is the commonest cause
- B. It commonly leads to ventricular fibrillation
- C. Intracardiac adrenaline is an absolute indication
- D. IV calcium gluconate is the first line of therapy
Correct Answer: A
Rationale: Hypoxia is the most common cause of asystole in children, emphasizing the importance of oxygenation during resuscitation.
The nurse is completing the preoperative assessment of a client who is scheduled for a laparoscopic cholecystectomy under general anesthesia. Which finding warrants notification of the healthcare provider prior to proceeding with the scheduled procedure?
- A. Light yellow coloring of the client's skin and eyes
- B. The client's blood pressure reading is 184/88 mm Hg.
- C. The client vomits 20 ml of clear yellowish fluid
- D. The IV insertion site is red, swollen, and leaking IV fluid
Correct Answer: B
Rationale: High blood pressure increases the risk of complications during surgery and needs to be addressed before proceeding.
Benign Rolandic seizures:
- A. Usually occurs at night
- B. Are difficult to control with drugs
- C. Centrotemporal spikes in EEG are a recognised feature
- D. Are more common than petit mal
Correct Answer: C
Rationale: Centrotemporal spikes on EEG are a hallmark feature of benign Rolandic epilepsy, a common childhood epilepsy syndrome.