Paediatric Nursing: NCK Exam Questions & Revision

A child has watery diarrhoea with sunken eyes and is drinking poorly. The most important immediate treatment is:

• A. Antibiotics
• B. Oral rehydration solution (or IV fluids if severe)
• C. Anti-diarrhoeal medicine
• D. Withholding all fluids

Why: Diarrhoea kills through dehydration. Rehydration with ORS (or IV fluids in severe dehydration) is the priority life-saving treatment.

Under IMCI, which is a general danger sign requiring urgent referral?

• A. A mild cough
• B. A runny nose
• C. Not able to drink or breastfeed
• D. A low-grade fever

Why: IMCI general danger signs include inability to drink or breastfeed, vomiting everything, convulsions, and lethargy or unconsciousness.

The recommended period of exclusive breastfeeding for an infant is:

• A. The first 3 months
• B. The first 6 months
• C. The first 9 months
• D. The first 12 months

Why: WHO and Kenyan guidelines recommend exclusive breastfeeding for the first 6 months, then continued breastfeeding with complementary foods.

In the case of Erb's palsy,

• A. There is damage to the lower brachial plexus involving the 7th and 8th cervical root nerves
• B. There is damage to the upper brachial plexus involving the 5th & 6th cervical root nerves
• C. There is damage to all the brachial plexus nerve roots
• D. There is damage to the facial nerve

Why: Erb's palsy is caused by damage to the upper brachial plexus, specifically involving the 5th and 6th cervical root nerves. This condition often results from trauma during childbirth, leading to weakness or paralysis of the arm. Option a describes Klumpke's palsy, which involves the lower brachial plexus (C8 and T1). Option c is incorrect as Erb's palsy does not involve all the brachial plexus nerve roots. Option d is incorrect as it pertains to facial nerve damage, unrelated to Erb's palsy.

A newborn weighing 1800 grams is admitted to the neonatal unit due to episodes of apnea. What type of environment should the baby be cared for in?

• A. Room temperature of 34°C-35°C, incubator temperature 35°C - 36°C.
• B. Room temperature of 33°C-34°C, incubator temperature 32°C - 34°C.
• C. Room temperature of 30°C-32°C, incubator temperature 32°C - 33°C.
• D. Room temperature of 28°C-30°C, incubator temperature 31°C - 32°C.

Why: A newborn weighing 1800 grams is considered low birth weight and may have difficulty maintaining body temperature. The correct environment for such a neonate is an incubator with a temperature of 35°C - 36°C, as this helps maintain the infant's body temperature and prevent hypothermia, which can exacerbate apnea. The room temperature should be slightly lower than the incubator to ensure the incubator can effectively regulate the infant's temperature. Options b, c, and d provide lower temperatures that are not suitable for a low birth weight infant, as they may lead to hypothermia.

What factors may contribute to non-organic growth failure (failure to thrive) in a child?

• A. A poor mother-child bond of attachment.
• B. Altered physiology due to improper feeding.
• C. Congenital disorders of metabolism.
• D. High incidence of child abuse.

Why: Non-organic growth failure, also known as failure to thrive, often results from environmental factors rather than medical conditions. A poor mother-child bond of attachment can lead to inadequate emotional and physical nurturing, which is crucial for a child's growth and development. Options b and c relate to organic causes, which are not the focus here. While child abuse (option d) can contribute to non-organic failure to thrive, it is more specific and less common than attachment issues.