Nokea
The following statements concerning acute gastroenteritis in childhood are correct:
- A. Intravenous fluid therapy is essential in severe cases
- B. Loperamide should be avoided
- C. The commonest causes of failure to thrive following an attack is persistent bacterial infection
- D. Septicaemia is a recognised feature of Salmonella gastroenteritis
Correct Answer: A
Rationale: Intravenous fluid therapy is critical in severe dehydration due to gastroenteritis. Loperamide is contraindicated in children due to risk of serious side effects. Persistent bacterial infection is not the commonest cause of failure to thrive, and septicaemia is rare in Salmonella gastroenteritis.
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Patients at risk for bacterial endocarditis include those with all of the following EXCEPT
- A. repaired simple atrial septic defect
- B. aortic stenosis
- C. rheumatic fever heart disease
- D. palliative vascular shunts
Correct Answer: A
Rationale: Repaired simple atrial septal defects are not considered a risk for bacterial endocarditis unless there are residual defects.
Which drug should not be used to control secondary hypertension in a sexually active adolescent female who uses intermittent birth control?
- A. Beta blockers
- B. Calcium channel blockers
- C. ACE inhibitors
- D. Diuretics
Correct Answer: C
Rationale: ACE inhibitors and angiotensin II receptor blockers are teratogenic and should be avoided in sexually active adolescents using birth control.
Psychosis in children is suggested by:
- A. Absence of speech
- B. Intense outbursts of temper
- C. Recurrence of bed-wetting following a period of control
- D. Feelings of depersonalisation
Correct Answer: D
Rationale: Feelings of depersonalisation are a hallmark of psychosis. Absence of speech and temper outbursts are nonspecific, and bed-wetting is not diagnostic.
A 70-year-old male client with type 2 diabetes mellitus (DM) is hospitalized with an infected ulcer on his great right toe. Which instruction should the nurse emphasize during discharge teaching?
- A. Check the insides and linings of all enclosed shoes before putting the shoes on
- B. Wash the feet with soap and water, then apply a topical antibiotic ointment.
- C. Trim toenails weekly to prevent injury.
- D. Avoid wearing sandals or open-toed shoes.
Correct Answer: A
Rationale: Preventing trauma to the feet is critical for clients with diabetes to avoid complications like infections and ulcers.
The following statements are true:
- A. Unexplained vaginal discharge in a 3-year-old might be a sign of sexual abuse
- B. Spiral fracture of femur is always non-accidental
- C. Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome
- D. Bruises on the elbows and knees in a 4-year-old are suggestive of physical abuse
Correct Answer: C
Rationale: Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome: Retinal bleeding in infants, especially with other signs of physical abuse, is a key indicator of 'shaken baby' syndrome.