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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What are FOUR possible causes of left axis deviation in a newborn with features of Trisomy 21?
- A. AVSD
- B. Tricuspid atresia
- C. Pulmonary atresia with intact ventricular septum
- D. Mechanical shift
Correct Answer: A
Rationale: AVSD is a common congenital heart defect associated with Trisomy 21 and can lead to left axis deviation seen on ECG.
The following enzymes and inhibitors are matched correctly:
- A. Xanthine oxidase-allopurinol
- B. Enolase-fluoride
- C. Cholinesterase-physostigmine
- D. Ceruloplasmin-penicillamine
Correct Answer: A
Rationale: Xanthine oxidase-allopurinol: Allopurinol inhibits xanthine oxidase, which plays a role in purine metabolism, and is used to treat gout and prevent uric acid buildup.
Which clinical manifestation is included in toxic shock syndrome?
- A. Severe hypertension
- B. Subnormal temperature
- C. Erythematous macular rash
- D. Papular rash over extremities
Correct Answer: C
Rationale: One of the diagnostic criteria for toxic shock syndrome is a diffuse macular erythroderma. Hypotension is one of the manifestations. Fever of 38.9° C or higher is a characteristic. Desquamation of the palms and soles of the feet occurs in about 1 to 2 weeks.
Which is not useful to test brainstem death in suspected cervical spine injury?
- A. Pupillary light reflex
- B. Doll's-eyes reflex
- C. Corneal reflex
- D. Oculo-vestibular reflex
Correct Answer: B
Rationale: Doll's-eyes reflex is not used in suspected cervical spine injury due to the risk of further injury.
Progressive spinal muscular atrophy of infancy presents with:
- A. Severe generalised weakness
- B. Fasciculations in the tongue
- C. Loss of spinothalamic tract function
- D. Spontaneous fibrillation on electromyography
Correct Answer: A
Rationale: Progressive spinal muscular atrophy presents with severe weakness and tongue fasciculations. Spinothalamic tract function is preserved, and electromyography shows fibrillation.
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