Nokea
The nurse is caring for a child who has undergone a cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurse's first action is to:
- A. Call the interventional cardiologist
- B. Notify the cardiac catheterization laboratory that the child will be returning
- C. Apply a bulky pressure dressing over the present dressing
- D. Apply direct pressure 1 inch above the puncture site
Correct Answer: D
Rationale: Direct pressure above the puncture site helps control bleeding by localizing pressure over the vessel.
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Management of a patient with an INR of 8.7 from warfarin overdose includes:
- A. Vitamin K
- B. Cryoprecipitate
- C. Fresh frozen plasma
- D. Desmopressin
Correct Answer: A
Rationale: The correct answer is A because vitamin K is the primary treatment for reversing warfarin overdose. The other options (b-e) are less commonly used or not indicated for this situation.
Manifestations of endocarditis include all of the following EXCEPT
- A. Gottron nodules
- B. hematuria
- C. petechiae
- D. splenomegaly
Correct Answer: A
Rationale: Gottron nodules are associated with dermatomyositis, not endocarditis.
Regarding resuscitation of a three-year old with asystole:
- A. Hypoxia is the commonest cause
- B. It commonly leads to ventricular fibrillation
- C. Intracardiac adrenaline is an absolute indication
- D. IV calcium gluconate is the first line of therapy
Correct Answer: A
Rationale: Hypoxia is the most common cause of asystole in children, emphasizing the importance of oxygenation during resuscitation.
These causes often cause secretory diarrhoea except:
- A. Lactose intolerance
- B. E. coli infection
- C. Congenital chloridorrhoea
- D. Blind loop syndrome
Correct Answer: A
Rationale: The correct answer is A because lactose intolerance causes osmotic diarrhoea, not secretory diarrhoea. The other options (b-e) are causes of secretory diarrhoea.
The following are recognised features of achondroplasia:
- A. Shortened spine
- B. Increased liability to pathological fractures
- C. Can be diagnosed radiologically at birth
- D. Infertility
Correct Answer: C
Rationale: Achondroplasia can be diagnosed radiologically at birth. The spine is not shortened, fractures are not increased, and infertility is not a feature.