The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, “Why do my child’s fingertips look like that?†On what understanding does the nurse base a response?
- A. Clubbing occurs as a result of untreated congestive heart failure.
- B. Clubbing occurs as a result of a left-to-right shunting of blood.
- C. Clubbing occurs as a result of decreased cardiac output.
- D. Clubbing occurs as a result of chronic hypoxia.
Correct Answer: D
Rationale: Clubbing of the fingers develops in response to chronic hypoxia.
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Dubowitz criteria to assess gestational age include:
- A. Skin colour
- B. Breast tissue
- C. Popliteal angle
- D. Moro reflex
Correct Answer: B
Rationale: Breast tissue is one of the criteria used in the Dubowitz assessment to estimate gestational age. Skin colour, popliteal angle, and Moro reflex are not part of the Dubowitz criteria.
Which type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?
- A. Neurogenic
- B. Cardiogenic
- C. Hypovolemic
- D. Anaphylactic
Correct Answer: D
Rationale: Anaphylactic shock results from extreme allergy or hypersensitivity to a foreign substance. Neurogenic shock results from loss of neuronal control, such as the interruption of neuronal transmission that occurs from a spinal cord injury. Cardiogenic shock is decreased cardiac output. Hypovolemic shock is a reduction in the size of the vascular compartment, decreasing blood pressure, and low central venous pressure.
Malabsorption may be seen in:
- A. Ischaemia of the gut
- B. Giardiasis
- C. Lymphoma of the ileum
- D. Chronic lead poisoning
Correct Answer: B
Rationale: Giardiasis, caused by the parasite Giardia lamblia, is a well-known cause of malabsorption.
Which among the following is a correct description for the condition 'mitral arcade'?
- A. Absent chordal insertions
- B. Absent papillary muscles
- C. Fused papillary muscles
- D. Elongated papillary muscles
Correct Answer: C
Rationale: Mitral arcade is characterized by fused papillary muscles.
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.