Nokea
Which is a major clinical manifestation of rheumatic fever?
- A. Polyarthritis
- B. Osler nodes
- C. Janeway spots
- D. Splinter hemorrhages of distal third of nails
Correct Answer: A
Rationale: Polyarthritis, which is swollen, hot, red, and painful joints, is a major clinical manifestation of rheumatic fever. The affected joints will change every 1 to 2 days. Primarily the large joints are affected. Osler nodes, Janeway spots, and splinter hemorrhages are characteristic of infective endocarditis.
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Regarding cisapride:
- A. It is licensed for use in children
- B. Fatal arrhythmias have been reported
- C. Concurrent administration with erythromycin is not advised
- D. It commonly causes constipation
Correct Answer: B
Rationale: Fatal arrhythmias have been reported: Cisapride, a gastrointestinal prokinetic agent, has been linked to fatal arrhythmias, particularly when combined with certain drugs like erythromycin.
José is a 4-year-old child scheduled for a cardiac catheterization. What should be included in preoperative teaching?
- A. Directed at his parents because he is too young to understand
- B. Detailed in regard to the actual procedures so he will know what to expect
- C. Done several days before the procedure so that he will be prepared
- D. Adapted to his level of development so that he can understand
Correct Answer: D
Rationale: Preoperative teaching should always be directed at the child’s stage of development. The caregivers also benefit from the same explanations. The parents may ask additional questions, which should be answered, but the child needs to receive the information based on developmental level. Preschoolers will not understand in-depth descriptions and should be prepared close to the time of the cardiac catheterization.
An infant aged 16 months was referred for assessment of suspected mental retardation. Which of the following findings is/are outside the normal range?
- A. He does not scribble spontaneously with pencil on paper
- B. He does not walk alone
- C. Ma' and 'Dada' are the only recognisable words
- D. He is unable to build a tower of four cubes
Correct Answer: B
Rationale: Not walking alone by 16 months is a concern. Scribbling, limited vocabulary, and building towers are less concerning at this age.
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.
Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?
- A. He is always hungry.
- B. He tires out during feedings.
- C. He is fussy for several hours every day.
- D. He sleeps all the time.
Correct Answer: B
Rationale: Fatigue during feeding or activity is common to most infants with congenital cardiac problems.