Which finding would alert a nurse that a hospitalized 6-year-old child is at risk for a severe asthma exacerbation?
- A. Oxygen saturation of 95%
- B. Mild work of breathing
- C. Absence of intercostals or substernal retractions
- D. History of steroid-dependent asthma
Correct Answer: D
Rationale: A history of steroid-dependent asthma indicates severe asthma, increasing the risk of a life-threatening exacerbation.
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Chest pain in pediatric patients often generates a significant amount of parental concern. Of the following, the MOST common cause is
- A. myocarditis
- B. pericarditis
- C. pneumonia
- D. pleurisy
Correct Answer: C
Rationale: Chest pain in children is most commonly caused by non-cardiac conditions such as pneumonia or pleurisy.
In a patient with painful joint swelling the following investigations are diagnostic:
- A. C-reactive protein
- B. Antinuclear antibodies
- C. Serum C3 (complement) levels
- D. Microscopic examination of synovial fluid
Correct Answer: D
Rationale: Microscopic examination of synovial fluid can reveal crystals, infection, or inflammation, providing a definitive diagnosis.
Pulmonary hypertension is a complication of:
- A. ASD
- B. Eisenmenger syndrome
- C. Tricuspid atresia
- D. Tricuspid regurgitation
Correct Answer: B
Rationale: Eisenmenger syndrome is a well-known cause of pulmonary hypertension. The other options (a-d) can also lead to pulmonary hypertension but are less specific.
Which among the following beta-blockers is not potent than propranolol (considering propranolol = 1)?
- A. Carvedilol
- B. Metoprolol
- C. Bisoprolol
- D. Labetalol
Correct Answer: D
Rationale: Labetalol has a lower beta-blocking potency compared to propranolol, especially considering it also has alpha-blocking activity.
Concerning SLE:
- A. Antibodies against double standard RNA are a typical finding
- B. Haematoxylin bodies occur in areas of inflammation
- C. Usually progresses to renal failure within two years
- D. Alopecia is a recognised finding
Correct Answer: D
Rationale: Alopecia is a recognized clinical feature of systemic lupus erythematosus (SLE), often associated with disease activity.