Nokea
A 4-year-old child is admitted to the hospital secondary to dehydration. Laboratory tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. Which condition does the nurse suspect based on the current data?
- A. Hypernatremia
- B. Metabolic acidosis
- C. Hypotonic dehydration
- D. Isotonic dehydration
Correct Answer: C
Rationale: The correct answer is hypotonic dehydration. The combination of high hemoglobin and hematocrit with low serum sodium indicates hypotonic dehydration. In this condition, there is an excess of solutes relative to water, leading to higher red blood cell concentration (elevated hemoglobin and hematocrit) and low serum sodium levels.
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A parent of a school-age child is receiving discharge teaching following a cardiac catheterization. Which of the following instructions should be included by the nurse?
- A. Allow the child to bathe 6 hours after the procedure.
- B. Keep the child on bed rest for 12 hours.
- C. Maintain a pressure dressing on the site for 8 hours.
- D. Resume regular activities the day after the procedure.
Correct Answer: B
Rationale: The correct instruction that the nurse should include is to keep the child on bed rest for 12 hours following a cardiac catheterization. This is important to prevent bleeding at the insertion site and ensure proper healing. Allowing the child to bathe soon after the procedure, maintaining a pressure dressing for only 8 hours, or resuming regular activities the day after the procedure can increase the risk of complications such as bleeding or infection.
Upper respiratory infections (URI) in children may increase the risk of reactive airway disease. Which of the following is NOT a typical feature of URI?
- A. Fever
- B. Clear rhinorrhea
- C. Injected sclerae
- D. Productive cough
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
You are evaluating a 6-year-old child with ALL on interim maintenance phase who has frequent mucositis and myelosuppression that needs frequent discontinuation of his treatment. Of the following, the MOST valuable test for this child is
- A. complete blood count
- B. pharmacogenetic testing of the thiopurine S-methyltransferase (TPMT) gene
- C. renal function test
- D. bone marrow study
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which statement by an 18-year-old woman vaccinated with Gardasil indicates that more teaching is necessary?
- A. This vaccination will cure the HPV infection I got when I was 16.
- B. I will still need to have a routine Pap screen performed.
- C. Gardasil can prevent genital warts in males and females.
- D. This drug does not protect against all types of HPV.
Correct Answer: A
Rationale: The correct answer is A because Gardasil does not cure existing HPV infections. Gardasil is a preventive vaccine and does not treat existing infections. Choice B is correct as regular Pap screenings are still necessary even after vaccination. Choice C is also correct as Gardasil can prevent genital warts. Choice D is correct as Gardasil does not protect against all types of HPV. Therefore, option A is the statement that indicates the need for more teaching.
In Langerhans cell histiocytosis (LCH), which organ is LEAST likely affected?
- A. skin
- B. ear
- C. bone
- D. middle nodes
Correct Answer: E
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.