Nokea
A 12-year-old girl has recently begun menstruating and is well into puberty. The child is visiting the health care provider today for a routine physical examination. Which finding should cause concern in the nurse?
- A. Breasts of slightly different sizes
- B. Irregular periods
- C. Vulvar irritation
- D. Supernumerary nipple
Correct Answer: C
Rationale: Vulvar irritation may indicate an infection or other issues and should be further evaluated. In a pubescent girl, breasts of slightly different sizes and irregular periods are common variations of normal development. Supernumerary nipple, an extra nipple, is a benign condition that is not typically concerning during puberty.
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A newborn has been diagnosed with Hirschsprung's disease. The parent asks the nurse about the symptoms that led to the diagnosis. Which symptoms should the nurse include in the response?
- A. Acute diarrhea and dehydration
- B. Current jelly-like stools and pain
- C. Failure to pass meconium and abdominal distension
- D. Projectile vomiting and altered electrolytes
Correct Answer: C
Rationale: The correct answer is C: Failure to pass meconium and abdominal distension. Hirschsprung's disease is commonly diagnosed in newborns due to the failure to pass meconium within the first 24-48 hours after birth and abdominal distension, indicating a bowel obstruction. Choices A, B, and D are incorrect because they do not correspond to the typical symptoms of Hirschsprung's disease. Acute diarrhea and dehydration, current jelly-like stools and pain, and projectile vomiting with altered electrolytes are not characteristic of this condition.
When taking a child's blood pressure, what percentage of the upper arm should the nurse ensure the cuff bladder width covers?
- A. 20%
- B. 40%
- C. 60%
- D. 80%
Correct Answer: B
Rationale: When taking a child's blood pressure, the nurse should select a cuff with a bladder width that covers 40% of the arm circumference at the midpoint of the upper arm. This ensures accurate readings. Choosing a cuff that covers less or more than 40% can lead to incorrect blood pressure measurements. Therefore, options A, C, and D are incorrect.
A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?
- A. Stimulate appetite
- B. Detect evidence of edema
- C. Minimize risk of infection
- D. Promote adherence to the antibiotic regimen
Correct Answer: C
Rationale: Prednisone, an immunosuppressant, increases the child's susceptibility to infections, making infection prevention a critical nursing goal. Detecting edema and stimulating appetite are important but secondary to preventing potentially life-threatening infections.
What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?
- A. Infarction of renal vessels
- B. Immune complex formation and glomerular deposition
- C. Bacterial endotoxin deposition on and destruction of glomeruli
- D. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation
Correct Answer: B
Rationale: Postinfectious glomerulonephritis is typically caused by immune complex deposition in the glomeruli following a streptococcal infection. This immune response leads to inflammation and impaired kidney function.
Which parental statement at the conclusion of a teaching session regarding environmental controls for childhood asthma indicates correct understanding of the information presented?
- A. ''We're glad the dog can continue to sleep in our child's room.''
- B. ''We'll keep the plants in our child's room dusted.''
- C. ''We'll be sure to use the fireplace often to keep the house warm in the winter.''
- D. ''We will replace the carpet in our child's bedroom with a hard surface.''
Correct Answer: D
Rationale: The correct answer is D. Replacing carpet with hard flooring helps to reduce allergens and asthma triggers in the child's environment. Choice A is incorrect as having a dog in the child's room can worsen asthma symptoms due to pet dander. Choice B is incorrect because keeping plants in the child's room can increase mold spores and allergens. Choice C is incorrect as using a fireplace can introduce smoke and other irritants into the air, worsening asthma symptoms.