Nokea
The mother of a toddler reports that the child's father has just had a myocardial infarction (MI). Because of this, the nurse recommends the child have a(n):
- A. Electrocardiogram
- B. Lipid profile
- C. Echocardiogram
- D. Cardiac catheterization
Correct Answer: B
Rationale: Current recommendations are for a lipid profile in children over 2 years of age who have a family history of cardiac events or high cholesterol.
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Regarding fluid and electrolyte homeostasis in a child:
- A. Normal maintenance requirement in a child weighing 20 kg is 1.5 litre/day
- B. A fluid deficit of 50ml/kg produces a body weight loss of 10%
- C. Hypotension is a useful sign ,which indicates moderate dehydration
- D. Normal maintenance needs of sodium are 5-6mmol/kg/day
Correct Answer: B
Rationale: A fluid deficit of 50ml/kg producing a 10% body weight loss is a well-established clinical guideline for assessing dehydration in children. Hypotension is a late sign of severe dehydration, not moderate dehydration.
Which of the following is a vasodilator?
- A. Thromboxane A2
- B. Endothelin
- C. Prostaglandin E2
- D. Urotensin II
Correct Answer: C
Rationale: Prostaglandin E2 is a vasodilator.
Dome and dart P wave in lead V1 in electrocardiogram is suggestive of which of the following?
- A. Dextrocardia
- B. Left atrial ectopic rhythm
- C. Biatrial enlargement
- D. Mitral stenosis
Correct Answer: C
Rationale: The dome and dart P wave morphology is characteristic of biatrial enlargement, often seen in conditions like mitral stenosis and atrial fibrillation.
Diagnostic signs of child abuse are:
- A. Sub-hyaloid bleeding
- B. Spiral fracture of a long bone
- C. Lacerated tongue
- D. Posterior rib fractures
Correct Answer: D
Rationale: Posterior rib fractures are highly suggestive of child abuse, as they are often caused by forceful squeezing or shaking.
Which assessment indicates that the parent of a 7-year-old is following the prescribed treatment for congestive heart failure (CHF)?
- A. HR of 56 beats per minute
- B. Elevated red blood cell count
- C. 50th percentile height and weight for age
- D. Urine output of 0.5 cc/kg/hr
Correct Answer: C
Rationale: Normal growth (50th percentile) indicates good nutrition and overall health, suggesting that CHF is well controlled.