Nokea
The following investigations are not needed in a 3-year old on TPN for the past 3 weeks:
- A. Serum selenium
- B. Serum manganese
- C. Serum iron
- D. Serum calcium
Correct Answer: C
Rationale: The correct answer is C because serum iron is not typically monitored in children on total parenteral nutrition (TPN). The other options (a, b, d, e) are commonly monitored to prevent deficiencies or toxicities.
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Management of thalassaemia includes:
- A. Whole blood transfusions
- B. Pneumovax
- C. Bone marrow transplant
- D. Penicillin V prophylaxis
Correct Answer: C
Rationale: The correct answer is C because bone marrow transplant is a curative treatment for thalassaemia. The other options (a, b, d, e) are supportive treatments but not curative.
Malignant mutation in hypertrophic cardiomyopathy is which of the following?
- A. Arg 403 Gln
- B. Gln 403 Arg
- C. Arg 304 Gln
- D. Gln 304 Arg
Correct Answer: A
Rationale: The Arg 403 Gln mutation is a known pathogenic mutation in hypertrophic cardiomyopathy, linked with a higher risk of sudden cardiac death.
In hyper cyanotic spells in Fallots tetralogy
- A. Hypoxia is there
- B. Murmur disappear
- C. Right to left shunt increases
- D. Acidosis occur
Correct Answer: C
Rationale: During hypercyanotic spells in Tetralogy of Fallot, the right-to-left shunt increases, leading to worsening cyanosis.
A female client who was involved in a motor vehicle collision with a fractured left femur which is immobilized using a fracture traction splint in preparation for an open reduction internal fixation (ORIF). The nurse determines that her distal pulses are diminished in the left foot. Which interventions should the nurse implement? Select all that apply.
- A. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure. Verify pedal pulses using a doppler pulse device. Evaluate the application of the splint to the left leg
- B. Verify pedal pulses using a Doppler pulse device
- C. Evaluate the application of the splint to the left leg.
- D. Administer pain medication to alleviate discomfort.
Correct Answer: A
Rationale: Monitoring for signs of compartment syndrome and verifying pulses are critical to ensure adequate circulation and prevent complications.
A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurse’s best response?
- A. Squatting increases the return of venous blood back to the heart.
- B. Squatting decreases arterial blood flow away from the heart.
- C. Squatting is a common resting position when a child is tachycardic.
- D. Squatting increases the workload of the heart.
Correct Answer: A
Rationale: The squatting position allows the child to breathe more easily because systemic venous return is increased.