The following are true about water excretion:
- A. It is influenced by the proximal tubule
- B. It is influenced by vasopressin
- C. It depends on erythropoietin
- D. It is influenced by the ascending limb of the loop of Henle
Correct Answer: B
Rationale: It is influenced by vasopressin: Vasopressin (ADH) regulates water reabsorption in the kidneys, primarily by acting on the collecting ducts, enhancing water retention in response to dehydration.
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In embryology:
- A. Most defects occur with teratogens in the first 2 weeks post-conception
- B. The urachus becomes the median umbilical ligament
- C. The mesonephric duct becomes the male organs
- D. The thyroid develops from the floor of the primitive larynx
Correct Answer: B
Rationale: The urachus becomes the median umbilical ligament. Most defects occur after the first 2 weeks, and the thyroid develops from the floor of the pharynx.
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.
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.
The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is:
- A. It is always helpful to get a second opinion about any serious condition like this.
- B. Your baby's defect is small and will likely close on its own by 1 year of age.
- C. It is common for physicians to wait until an infant develops respiratory distress before they do the surgery.
- D. With a small defect like this, they wait until the child is 10 years old to do the surgery.
Correct Answer: B
Rationale: Most small VSDs close spontaneously within the first year of life.
Which congenital cardiac defect(s) cause(s) increased pulmonary blood flow? (Select all that apply.)
- A. Atrial septal defects (ASDs)
- B. Tetralogy of Fallot
- C. Dextroposition of aorta
- D. Patent ductus arteriosus
Correct Answer: D
Rationale: The congenital heart defects that cause increased pulmonary blood flow are ASDs, VSDs, and patent ductus arteriosus.