Nokea
The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is:
- A. It is always helpful to get a second opinion about any serious condition like this.
- B. Your baby's defect is small and will likely close on its own by 1 year of age.
- C. It is common for physicians to wait until an infant develops respiratory distress before they do the surgery.
- D. With a small defect like this, they wait until the child is 10 years old to do the surgery.
Correct Answer: B
Rationale: Most small VSDs close spontaneously within the first year of life.
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Medical treatment of myasthenia gravis includes:
- A. Thymectomy
- B. Physostigmine
- C. Edrophonium
- D. Anticholinergic agents
Correct Answer: C
Rationale: Edrophonium: Edrophonium is used in the diagnosis and short-term treatment of myasthenia gravis as it improves neuromuscular transmission by inhibiting acetylcholinesterase.
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.
Childhood autism:
- A. Is commoner in boys
- B. Is characterised by extreme delay of social milestones
- C. Repetitive tasks are commonly performed
- D. Is characterised by extremely chaotic routines
Correct Answer: A
Rationale: Autism spectrum disorder is more commonly diagnosed in boys than girls, with a male-to-female ratio of approximately 4:1.
Abnormal coloration of the urine (in the absence of haematuria) may be due to:
- A. Consumption of beetroot
- B. Treatment with co-danthramer
- C. Phenylketonuria
- D. Acute intermittent porphyria
Correct Answer: A
Rationale: Beetroot can cause red urine. Co-danthramer, phenylketonuria, and porphyria can also cause abnormal urine color, but beetroot is a common cause.
SVT in children differ from physiologic sinus tachycardia by all the following EXCEPT
- A. sudden onset and termination
- B. persistent ventricular rate of >180 bpm
- C. fixed RR interval on ECG
- D. evident change in heart rate with activity
Correct Answer: D
Rationale: Physiologic sinus tachycardia can show changes in heart rate with activity, unlike SVT which has a fixed rate.