Nokea
When planning care for a 8-year-old boy with Down syndrome, the nurse should:
- A. Plan interventions according to the developmental level of a 7-year-old child because that’s the child’s age
- B. Plan interventions according to the developmental levels of a 5-year-old because the child will have developmental delays
- C. Assess the child’s current developmental level and plan care accordingly
- D. Direct all teaching to the parents because the child can’t understand
Correct Answer: C
Rationale: Care should be individualized based on the child’s current developmental level, not just their chronological age or assumptions about delays.
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What is the age-predicted maximum heart rate in a 60-year old man on beta blockers?
- A. 122
- B. 133
- C. 155
- D. 166
Correct Answer: A
Rationale: Beta blockers reduce the maximum heart rate. The age-predicted maximum heart rate for a 60-year-old on beta blockers is approximately 122 bpm.
What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta?
- A. Blood pressure higher on the right side
- B. Blood pressure higher on the left side
- C. Blood pressure lower in the arms than in the legs
- D. Blood pressure lower in the legs than in the arms
Correct Answer: D
Rationale: The characteristic symptoms of coarctation of the aorta are a marked difference in blood pressure and pulses between the upper and lower extremities. Pressure is increased proximal to the defect and decreased distal to the coarctation.
During play, a toddler with a history of tetralogy of Fallot (TOF) might assume which position?
- A. Sitting
- B. Supine
- C. Squatting
- D. Standing
Correct Answer: C
Rationale: Squatting naturally increases SVR by occluding venous return from the lower extremities, thereby increasing pulmonary blood flow.
An 18-months old infant weighing 10 kg develops an acute anaphylactic reaction with bronchospasm towards antibiotic injection. What is the most appropriate initial treatment?
- A. Inj. Hydrocortisone 100 mg IV stat
- B. Inj. Epinephrine 0.1 mg IV / IM stat
- C. Inj. Epinephrine 0.01 mg IV/IM stat
- D. Nebulization Salbutamol + oxygen
Correct Answer: C
Rationale: The most appropriate initial treatment for anaphylaxis in a child is intramuscular epinephrine at a dose of 0.01 mg/kg, which is 0.1 mg for a 10 kg child.
Recognised associations of Addison's disease include:
- A. Neurofibromatosis
- B. Phaeochromocytoma
- C. IDDM
- D. Nephrogenic diabetes insipidus
Correct Answer: C
Rationale: The correct answer is C because IDDM (insulin-dependent diabetes mellitus) is a recognized association of Addison's disease. The other options (a, b, d, e) are less commonly associated.