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When receiving change-of-shift report for children, which child should the nurse assess first?
- A. A toddler who has a concussion and an episode of forceful vomiting
- B. An adolescent with infective endocarditis who reports having a headache
- C. An adolescent who was placed into Halo traction 1 hour ago and rates his pain at a 6 on a 0-10 scale
- D. A school-age child with acute glomerulonephritis and brown-colored urine
Correct Answer: A
Rationale: The nurse should assess the toddler with a concussion and an episode of forceful vomiting first when receiving change-of-shift report for children. Forceful vomiting in a toddler with a concussion indicates increased intracranial pressure, requiring immediate assessment and intervention to prevent further complications.
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A diabetic client develops sinusitis and otitis media accompanied by a fever of 100.8â—‹0 F (38.2â—‹0 C). What effect may this have on his need for insulin?
- A. It will have no effect.
- B. it will cause wide fluctuations in the
- C. it will decrease the need insulin. need for insulin
- D. It will increase the need for insulin.
Correct Answer: D
Rationale: When a diabetic client develops an infection, such as sinusitis and otitis media with a fever, the stress response can increase blood glucose levels. Infections trigger the release of stress hormones like cortisol and adrenaline, which can lead to insulin resistance. Insulin requirements may increase during an infection due to the elevated blood glucose levels and the body's increased demand for energy to fight the infection. Therefore, the diabetic client with sinusitis and otitis media accompanied by a fever of 100.8°F (38.2°C) will likely require an increase in their insulin dosage to help control their blood glucose levels during this period.
Parents tell the nurse that their child keeps scratching the areas where he has poison ivy. The nurse's response should be based on which knowledge?
- A. Poison ivy does not itch and needs further investigation.
- B. Scratching the lesions will not cause a problem.
- C. Scratching the lesions will cause the poison ivy to spread.
- D. Scratching the lesions may cause them to become secondarily infected.
Correct Answer: D
Rationale: Scratching the lesions caused by poison ivy may result in them becoming secondarily infected. It is important to advise against scratching the affected areas to prevent the introduction of bacteria from under the fingernails or through broken skin, which can lead to infection. This can complicate the initial skin irritation caused by the poison ivy rash. Encouraging the child to avoid scratching and keeping the affected areas clean can help prevent secondary infections and promote healing.
The MOST common cause of sleeping difficulty in the first 2 months of life is
- A. gastroesophageal reflux
- B. colic
- C. formula intolerance
- D. developmentally self-resolving sleeping behavior
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Renal cell carcinoma (RCC) is rare in children, accounting for <5% of all renal tumors. All the following are true regarding RCC in children EXCEPT
- A. patients may present with frank hematuria, flank pain, and/or a palpable mass
- B. it can be asymptomatic and detected incidentally
- C. it has a propensity to metastasize to the lungs, bone, liver, and brain
- D. it can be associated with von Hippel-Lindau disease
Correct Answer: E
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which feature is NOT characteristic of autistic spectrum disorder?
- A. Defective social communication
- B. Fixated interests
- C. Highly restricted routines
- D. Stereotyped absence of motor use
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.