The treatment of choice for the lesion of the neonate is
- A. digoxin
- B. propranolol (Inderal)
- C. surgical shunt
- D. balloon valvuloplasty
Correct Answer: D
Rationale: Balloon valvuloplasty can relieve pulmonary stenosis and improve symptoms in Tetralogy of Fallot.
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Distal renal tubular acidosis:
- A. Is characterised by hypokalaemia
- B. May be primary or secondary
- C. Presents with growth failure in infancy
- D. Urinary pH is usually < 5
Correct Answer: B
Rationale: Distal renal tubular acidosis (RTA) can be either primary (inherited) or secondary (acquired due to other conditions), affecting acid excretion in the distal tubule.
Cantwell criteria is used to diagnose
- A. Congenital tuberculosis
- B. Congenital syphilis
- C. Congenital rubella
- D. None of the above
Correct Answer: B
Rationale: The Cantwell criteria are used to diagnose congenital syphilis, based on clinical and laboratory findings.
Which therapeutic management should the nurse expect to implement for a child with rheumatic fever?
- A. Administering penicillin
- B. Avoiding salicylates (aspirin)
- C. Imposing strict bed rest for 4 to 6 weeks
- D. Administering corticosteroids if chorea develops
Correct Answer: A
Rationale: The goal of medical management is the eradication of the hemolytic streptococci. Penicillin is the drug of choice. Salicylates can be used to control the inflammatory process, especially in the joints, and reduce the fever and discomfort. Bed rest is recommended for the acute febrile stage, but it does not need to be strict. The chorea is transient and will resolve without treatment.
A psychiatric referral is warranted in a preschool child with the following:
- A. Night terrors
- B. Separation anxiety
- C. Scared of ghosts
- D. Masturbation
Correct Answer: B
Rationale: Separation anxiety in a preschool child, especially if it is severe and persistent, may warrant a psychiatric referral to assess for anxiety disorders.
A healthcare worker with no known exposure to tuberculosis has received a Mantoux tuberculosis skin test. The nurse's assessment of the test after 62 hours indicates 5 mm of erythema without induration. What is the best initial nursing action?
- A. Document negative results in the client's medical record
- B. Repeat the test immediately on the opposite forearm
- C. Notify the healthcare provider for further evaluation
- D. Schedule the worker for a chest X-ray
Correct Answer: A
Rationale: Erythema without induration is not considered a positive result. Documentation of negative findings is appropriate.