Nokea
The following conditions are associated with hyperammonaemia:
- A. Reye syndrome
- B. Citrullinaemia
- C. Methylmalonic acidaemia
- D. Homocystinuria
Correct Answer: A
Rationale: Reye syndrome is associated with hyperammonaemia due to liver dysfunction and impaired urea cycle function, leading to ammonia accumulation.
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Hypothalamic nuclei are responsible for:
- A. Control of hunger
- B. Temperature control
- C. Maintaining osmolarity of extracellular fluid
- D. Secretion of thyrotrophin
Correct Answer: A
Rationale: The hypothalamus plays a key role in regulating hunger through various nuclei and hormonal signals.
An asymptomatic 45-year old male with newly diagnosed atrial fibrillation and normal echo, refused cardioversion while suggested. The next optimal management strategy for him is
- A. Sedate and cardiovert against patient wishes
- B. Aspirin
- C. Anticoagulation
- D. Rate control
Correct Answer: D
Rationale: Rate control is the optimal management strategy for asymptomatic atrial fibrillation when cardioversion is refused.
A child born with Down syndrome should be evaluated for which associated cardiac manifestation?
- A. Congenital heart defect (CHD)
- B. Systemic hypertension
- C. Hyperlipidemia
- D. Cardiomyopathy
Correct Answer: A
Rationale: CHD is found frequently in children with Down syndrome.
An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?
- A. I get short of breath when I climb stairs.
- B. I see halos floating around my head.
- C. I have trouble remembering things.
- D. I have lost weight over the past month.
Correct Answer: A
Rationale: Shortness of breath, especially during exertion, is a classic symptom of heart failure due to the heart's inability to pump blood effectively.
A 12-year-old child whose body mass index (BMI) is greater than the 95th percentile has a blood pressure at the 98th percentile for age, sex, and height. After lifestyle changes that include diet and exercise, the child's BMI drops to the 90th percentile, but the blood pressure remains the same. What is the primary care pediatric nurse practitioner's next step in treating this child?
- A. Continued close monitoring of blood pressure
- B. Ordering an echocardiogram
- C. Prescribing an ACE inhibitor medication
- D. Referral to a nephrologist or cardiologist
Correct Answer: D
Rationale: Children who have persistent BP elevation after lifestyle changes are made should be referred to a nephrologist or cardiologist who has experience using antihypertensive agents in children.