Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely “asleep†during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: D
Rationale: The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.
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The following favour a non-organic (psychological) cause of abdominal pain:
- A. Two-year history
- B. Family history of peptic ulcer
- C. Family history of migraine
- D. Absence from school
Correct Answer: A
Rationale: A long history of abdominal pain without organic findings suggests a psychological cause. Family history of peptic ulcer or migraine is less relevant.
A nurse is caring for a child with Down syndrome. Which statement by the parent indicates the need for further teaching?
- A. I will make sure my child has regular hearing screenings.
- B. I will encourage my child to be active and participate in play.
- C. I should monitor my child's thyroid function regularly.
- D. I should avoid giving my child a multivitamin supplement.
Correct Answer: D
Rationale: Children with Down syndrome may benefit from a multivitamin supplement, especially if they are at risk for nutritional deficiencies.
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.
Accepted maintenance treatment for chronic asthma includes the following:
- A. High-dose inhaled steroids and long-acting bronchodilators
- B. Montelucast
- C. Montelucast and inhaled steroids
- D. Long-acting ~2-agonists alone
Correct Answer: A
Rationale: The correct answer is A because high-dose inhaled steroids and long-acting bronchodilators are the mainstay of chronic asthma management. The other options (b-e) are less commonly used or not first-line.
All of the following are minor criteria in the latest Revised Jones criteria for rheumatic fever in moderate-high risk population except
- A. Monoarthalgia
- B. Fever with body temperature ≥ 38.5°C
- C. ESR 230 mm/hour
- D. Prolonged PR interval
Correct Answer: C
Rationale: ESR 230 mm/hour is not a minor criterion in the Revised Jones criteria for rheumatic fever.
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