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A 4-year-old boy presents with fever, limp, and hip pain. Hip x-ray is normal, but ESR is elevated. Most likely diagnosis is:
- A. Septic arthritis
- B. Transient synovitis
- C. Osteomyelitis
- D. Slipped capital femoral epiphysis
Correct Answer: B
Rationale: Transient synovitis is common in preschoolers with limp and fever, often post-viral, with normal x-ray, per AAP. A, C-E have different presentations or imaging.
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A child is diagnosed with hypoalbuminemia. Her total serum calcium level is normal. Most likely associated finding that may be missed is:
- A. Hypocalcemia
- B. Hypercalcuria
- C. Hypomagnesemia
- D. Hypercalcemia
Correct Answer: D
Rationale: Hypoalbuminemia lowers bound calcium; a normal total calcium suggests hypercalcemia in ionized form, often missed (UpToDate). A-C, E don’t fit.
The nurse prepares a child to receive oxygen via a tent delivery system by allowing the child to place a teddy bear in and out of the tent and then rewarding the child with a sticker. Which practice is the nurse using?
- A. Therapeutic play
- B. Therapeutic rewards
- C. Therapeutic interventions
- D. Therapeutic communication
Correct Answer: A
Rationale: Using a teddy bear to familiarize the child with the oxygen tent is therapeutic play, reducing fear through familiar objects.
In administering vitamin K to the infant shortly after birth, the nurse understands that vitamin K is
- A. Synthesized by the kidneys
- B. Not initially synthesized because of sterile bowel at birth
- C. Given to enhance lung function
- D. Produced by the liver immediately
Correct Answer: B
Rationale: Not initially synthesized because of sterile bowel at birth B explains the need for vitamin K to prevent hemorrhagic disease, per document .
A 2-year-old with croup requires
- A. Antibiotics
- B. Cool mist
- C. Hot steam
- D. Oxygen therapy
Correct Answer: B
Rationale: Cool mist B relieves croup symptoms, per document p22, 4.
A newborn girl appears with ambiguous genitalia and a 46,XX karyotype. Labs reveal elevated 17-hydroxyprogesterone. Most likely diagnosis is:
- A. Congenital adrenal hyperplasia
- B. Androgen insensitivity syndrome
- C. Gonadal dysgenesis
- D. 5-alpha reductase deficiency
Correct Answer: A
Rationale: CAH fits XX karyotype and elevated 17-OHP, per AAP (doc p149, Q574).