Nokea
Which of the following statements is true regarding Glasgow coma scale (GCS) in children?
- A. The scale is validated as a prognostic scoring system in children and young infants
- B. Patients with GCS < or = 8 require aggressive management
- C. All patients with GCS < or = 5 should be intubated and mechanically ventilated
- D. It is useful in children to assess the neurological, circulatory and cardiac status
Correct Answer: B
Rationale: Patients with a GCS of 8 or less require aggressive management, as this indicates severe brain injury and potential airway compromise.
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Biochemical abnormalities in a chronic carrier of hepatitis B are:
- A. Raised AST
- B. Low serum albumin
- C. Raised gamma GT
- D. Raised transferrin
Correct Answer: A
Rationale: The correct answer is A because chronic hepatitis B carriers often have raised AST (aspartate aminotransferase) due to liver inflammation. The other options are less specific or not typically associated with chronic hepatitis B.
All of the following are true about a small VSD EXCEPT
- A. spontaneous closure is more common in muscular vs. membranous defects
- B. closure usually occurs in the first 2 years of life
- C. there is no risk of endocarditis
- D. pulmonary pressures are normal
Correct Answer: C
Rationale: Even small VSDs carry a risk of endocarditis until they close.
Which of the following is a vasodilator?
- A. Thromboxane A2
- B. Endothelin
- C. Prostaglandin E2
- D. Urotensin II
Correct Answer: C
Rationale: Prostaglandin E2 is a vasodilator.
The mother of a toddler reports that the child's father has just had a myocardial infarction (MI). Because of this, the nurse recommends the child have a(n):
- A. Electrocardiogram
- B. Lipid profile
- C. Echocardiogram
- D. Cardiac catheterization
Correct Answer: B
Rationale: Current recommendations are for a lipid profile in children over 2 years of age who have a family history of cardiac events or high cholesterol.
A psychiatric referral is warranted in a preschool child with the following:
- A. Night terrors
- B. Separation anxiety
- C. Scared of ghosts
- D. Masturbation
Correct Answer: B
Rationale: Separation anxiety in a preschool child, especially if it is severe and persistent, may warrant a psychiatric referral to assess for anxiety disorders.