The most common cause of bacterial meningitis in children under 5 years is:
- A. Neisseria meningitidis
- B. Haemophilus influenzae
- C. Streptococcus pneumoniae
- D. Listeria monocytogenes
Correct Answer: C
Rationale: Streptococcus pneumoniae is the leading cause of bacterial meningitis in children under 5 years, especially in those who are not immunized.
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Tall (>25 mm), narrow, and spiked P waves are seen in
- A. Ebstein anomaly
- B. ventricular septal defect
- C. patent ductus arteriosus
- D. severe mitral stenosis
Correct Answer: D
Rationale: Severe mitral stenosis can cause tall, narrow, and spiked P waves due to left atrial enlargement.
All the following are signs of coarctation of the aorta EXCEPT
- A. femoral pulses are weak or absent
- B. bounding pulses of the arms
- C. blood pressure in the legs is lower than that in the arms
- D. precordial impulse and heart sounds are usually normal
Correct Answer: B
Rationale: In coarctation of the aorta, femoral pulses are delayed or absent, not bounding.
Which is the incorrect statement regarding effect of dobutamine infusion in patients with heart failure
- A. Left ventricular end diastolic pressure decreases
- B. Mean arterial pressure decreases slightly due to interplay of actions on alpha 1 and alpha 2 receptors
- C. Left ventricular end systolic volume decreases
- D. There is increased myocardial oxygen demand
Correct Answer: B
Rationale: Mean arterial pressure typically increases, not decreases, with dobutamine infusion due to its inotropic effects.
Clinical manifestations of hypoplastic left-heart syndrome in the 1st 48 hr of life include
- A. always obvious color
- B. deep-blue skin
- C. bounding peripheral pulses
- D. occasional association with Turner syndrome
Correct Answer: C
Rationale: Bounding peripheral pulses are not typical in hypoplastic left-heart syndrome.
The nurse reviews the laboratory results of a client during an annual physical examination and identifies a positive guaiac test of stool. Which additional serum laboratory test result should the nurse review?
- A. Glucose
- B. Platelet count
- C. White blood cell count
- D. Amylase
Correct Answer: B
Rationale: A positive guaiac test indicates gastrointestinal bleeding. A platelet count is essential to assess for thrombocytopenia, which could contribute to bleeding.