Nokea
When caring for an 11-month-old infant with dehydration and metabolic acidosis, the nurse expects to see which of the following?
- A. A reduced white blood cell count
- B. A decreased platelet count
- C. Shallow respirations
- D. Tachypnea
Correct Answer: D
Rationale: Tachypnea is a compensatory mechanism in metabolic acidosis to help expel excess carbon dioxide and correct the acid-base imbalance.
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Causes of a discrete osteolytic bone lesion in a two-year-old include:
- A. Rickets
- B. Non-accidental injury
- C. Eosinophilic granuloma
- D. Acute lymphoblastic leukaemia
Correct Answer: C
Rationale: Eosinophilic granuloma is a benign bone lesion that can present with osteolytic lesions, typically seen in children as part of Langerhans cell histiocytosis.
A 6-year-old child has a systolic blood pressure between the 95th and 99th percentile for age, sex, and height and a diastolic blood pressure between the 90th and the 95th percentile on three separate clinic visits. This child's blood pressure is placed in which classification?
- A. normotensive
- B. pre-hypertensive
- C. stage 1 hypertensive
- D. stage 2 hypertensive
Correct Answer: C
Rationale: Stage 1 hypertensive pressure ranges from the 95th percentile or from 120/80 mm Hg to 5 mm Hg above the 99th percentile for age, sex, and height for either systolic or diastolic pressure.
One of the following is a sign of right-sided heart failure of the patient
- A. tachypnea
- B. orthopnea
- C. wheezing
- D. pulmonary edema
Correct Answer: B
Rationale: Right-sided heart failure typically presents with systemic signs like orthopnea and peripheral edema rather than pulmonary edema.
Epiphyseal changes are seen in:
- A. Non-accidental injury
- B. Rickets
- C. Chronic renal failure
- D. Lead poisoning
Correct Answer: B
Rationale: Rickets is characterized by epiphyseal changes due to defective mineralization of growing bones.
In childhood asthma:
- A. Over 90% of patients show exercise-induced bronchoconstriction
- B. Hypercapnia is the first physiological disturbance in status asthmaticus
- C. Infants are unresponsive to bronchodilators
- D. Spontaneous cure occurs before adolescence
Correct Answer: D
Rationale: Spontaneous cure before adolescence is a recognized phenomenon in childhood asthma, though not all cases resolve. Other options are incorrect: exercise-induced bronchoconstriction is common but not universal, hypercapnia occurs late in status asthmaticus, and infants do respond to bronchodilators.