1.Easy
At about what age can most children copy a circle with a crayon?
- AAbout 3 years
- BAbout 12 months
- CAbout 6 years
- DAbout 18 months
2.Easy
What is a positive Brudzinski sign?
- AThe child cannot straighten the knee when the hip is flexed
- BThe toes fan out when the sole of the foot is stroked
- CBending the neck forward causes the hips and knees to flex
- DThe pupils become unequal in size after a head injury
3.Easy
Which vaccine has made acute epiglottitis much less common in children?
- APneumococcal conjugate vaccine
- BHaemophilus influenzae type b (Hib) vaccine
- CRotavirus vaccine given by mouth
- DMeasles–mumps–rubella (MMR) vaccine
4.Medium
Which finding suggests repeated self-induced vomiting?
- ASwelling of the ankles and puffy eyes
- BA butterfly rash on the cheeks and patchy hair loss
- CCalluses on the knuckles and loss of tooth enamel
- DYellow skin, itching and dark urine
5.Medium
At about what age does a pincer grasp (picking up small objects between thumb and index finger) typically develop?
- AAbout 9 to 10 months
- BAbout 18 months
- CAbout 3 months
- DAbout 2 years
6.Medium
After a cardiac catheterisation through the femoral artery, which assessment is essential?
- APulse, colour, warmth and sensation of the leg below the puncture site
- BBowel sounds, abdominal girth and stool colour every 15 minutes for the first hours
- CPupil size and reaction every 15 minutes
- DUrine specific gravity at every void
7.Hard
A 3-month-old has large, flat, blue-grey patches over the lower back and buttocks. The parents say they have been there since birth. What is the best action?
- AApply cold packs several times a day to reduce the discoloration
- BReport them straight away to the safeguarding team as suspected physical abuse
- CDocument them with size and location as congenital dermal melanocytosis (Mongolian spots)
- DRequest urgent clotting tests and a full blood count to look for a bleeding disorder
8.Hard
A 2-month-old is brought in with bruises on both cheeks. The parent says the baby "bumps into things". What should the nurse do?
- ADocument the findings objectively and follow the safeguarding procedure to report the concern
- BAccept the explanation because babies often bump into things
- CTell the parent that a report will be made, then let them take the baby home before it is reviewed
- DAccuse the parent of abuse in front of other families
Answer key
- 1. A · About 3 years
- 2. C · Bending the neck forward causes the hips and knees to flex
- 3. B · Haemophilus influenzae type b (Hib) vaccine
- 4. C · Calluses on the knuckles and loss of tooth enamel
- 5. A · About 9 to 10 months
- 6. A · Pulse, colour, warmth and sensation of the leg below the puncture site
- 7. C · Document them with size and location as congenital dermal melanocytosis (Mongolian spots)
- 8. A · Document the findings objectively and follow the safeguarding procedure to report the concern
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