Nokea
The most common cause for testicular pain in boys in 2-10 years of age is
- A. Testicular torsion
- B. Torsion of appendix testis
- C. Epididymitis
- D. Congenital varicocele
Correct Answer: B
Rationale: Torsion of the appendix testis is the most common cause of testicular pain in boys aged 2-10 years, as it involves the twisting of a small vestigial remnant.
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Which of the following statements is true regarding Glasgow coma scale (GCS) in children?
- A. The scale is validated as a prognostic scoring system in children and young infants
- B. Patients with GCS < or = 8 require aggressive management
- C. All patients with GCS < or = 5 should be intubated and mechanically ventilated
- D. It is useful in children to assess the neurological, circulatory and cardiac status
Correct Answer: B
Rationale: Patients with a GCS of 8 or less require aggressive management, as this indicates severe brain injury and potential airway compromise.
A 2-year-old child should be able to:
- A. Name three colours correctly
- B. Use plurals
- C. Build a tower of five blocks
- D. Kick a ball on request
Correct Answer: C
Rationale: A 2-year-old can typically build a tower of five blocks. Naming colors and using plurals are more advanced skills, and kicking a ball is variable.
An emergency department nurse triages clients who present with chest discomfort. Which client should the nurse plan to assess first?
- A. A 42-year-old female who describes her pain as a dull ache with numbness in her fingers
- B. A 49-year-old male reports moderate pain that is worse on inspiration
- C. A 53-year-old female reports substernal pain that radiates to her abdomen
- D. A 58-year-old male describes his pain as an intense stabbing that spreads across his chest
Correct Answer: D
Rationale: Intense stabbing chest pain that spreads across the chest is highly suggestive of an acute cardiac event, such as a myocardial infarction, and requires immediate assessment.
A 6-year-old child has a systolic blood pressure between the 95th and 99th percentile for age, sex, and height and a diastolic blood pressure between the 90th and the 95th percentile on three separate clinic visits. This child's blood pressure is placed in which classification?
- A. normotensive
- B. pre-hypertensive
- C. stage 1 hypertensive
- D. stage 2 hypertensive
Correct Answer: C
Rationale: Stage 1 hypertensive pressure ranges from the 95th percentile or from 120/80 mm Hg to 5 mm Hg above the 99th percentile for age, sex, and height for either systolic or diastolic pressure.
Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)?
- A. Chickenpox or influenza
- B. E. coli or staphylococcus
- C. Mumps or streptococcus A
- D. Streptococcus A or staphylococcus
Correct Answer: A
Rationale: Both chickenpox and influenza are viral; during these illnesses, aspirin (a salicylate) is typically discontinued due to the risk of Reye syndrome.