A 1-year-old child develops right eye ptosis, miosis, and loss of sweating; you suspect neuroblastoma. The MOST valuable investigation to confirm the diagnosis is
- A. CT scan of the neck and chest
- B. CT scan of the abdomen
- C. CT scan of the brain
- D. magnetic resonance imaging (MRI) of the brain
Correct Answer: A
Rationale: CT scan of the neck and chest can help identify a primary neuroblastoma mass in the adrenal gland or sympathetic chain.
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One of the following is not a feature of attention deficit/hyperactivity disorder (ADHD)
- A. ADHD is multifactorial in origin
- B. female to male ratio is 2 to 6:1
- C. prenatal exposure to nicotine increases the risk of ADHD.
- D. lead intoxication
Correct Answer: D
Rationale: Lead intoxication is not a recognized feature of ADHD but rather a separate condition with its own set of symptoms.
The nurse teaches a diabetic client that diet plays a crucial role in managing diabetes mellitus. When evaluating dietary intake, the nurse knows the client is eating the right foods if total daily caloric intake consists of:
- A. 30% to 35% carbohydrate, 40% fat, and 25% to 30% protein
- B. 40% to 45% carbohydrate, 40% fat, and 15% to 20% protein
- C. 50% to 55% carbohydrate, 35% fat, and 10% to 15% protein
- D. 55% to 60% carbohydrate, 30% fat and 10% to 15% protein
Correct Answer: A
Rationale: In managing diabetes mellitus, one of the key principles is proper macronutrient distribution in the diet. The recommended dietary intake for a diabetic client typically includes a moderate amount of carbohydrates (30% to 35% of total calories) in order to help control blood sugar levels. Including higher amounts of fat (around 40%) can be beneficial in managing this condition as well. Adequate protein intake (25% to 30%) is also important for overall health and satiety. This balanced macronutrient distribution helps in maintaining stable blood sugar levels throughout the day, supporting optimal diabetes management.
Where would nonpathologic cyanosis normally be present in the newborn shortly after birth?
- A. Feet and hands
- B. Bridge of nose
- C. Circumoral area
- D. Mucous membranes
Correct Answer: D
Rationale: Nonpathologic cyanosis in newborns shortly after birth is typically seen in the mucous membranes, such as the lips and oral mucosa. This transient cyanosis is caused by the normal physiologic response of the newborn's immature circulatory system adjusting to extrauterine life. As oxygenation improves and blood circulation stabilizes, the cyanosis will usually resolve within the first few days after birth. It is important for healthcare providers to distinguish between pathologic and nonpathologic cyanosis in newborns to ensure appropriate management and monitoring.
Granulocytic sarcoma masses are commonly seen in which type of the following malignancies?
- A. neuroblastoma
- B. rhabdomyosarcoma
- C. soft tissue sarcoma
- D. AML
Correct Answer: D
Rationale: Granulocytic sarcoma is most commonly associated with acute myeloid leukemia (AML).
The LEAST important advice for a 2-month-old baby with excessive crying is
- A. master the situation in relaxed manner
- B. adhere to precry cues
- C. change milk formula
- D. avoid sensory overstimulation
Correct Answer: C
Rationale: Changing formula is less critical if the baby is gaining weight adequately.