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A 13-year-old is worried because his breasts are growing and are tender. What should the nurse tell him?
- A. We will draw blood to determine the cause.
- B. It is a slight hormonal imbalance that can be corrected with medication.
- C. It is a normal condition of puberty (gynecomastia) that usually resolves within a year or two.
- D. It is a rare finding in boys during puberty.
Correct Answer: C
Rationale: Gynecomastia and breast tenderness occur in about one-third of boys during mid-puberty and usually resolve within 2 years.
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Burns are commonly seen in child abuse. Approximately 10% of children hospitalized with burns are victims of abuse. Of the following, inflicted burn can be MOST commonly the result of
- A. contact with hot iron
- B. contact with radiators
- C. cigarette application
- D. scalding injuries
Correct Answer: D
Rationale: Scalding injuries, often caused by hot liquids, are the most common type of inflicted burns in child abuse due to their accessibility and ease of use.
Although melanoma is relatively rare in children, some risk factors may increase its incidence. All the following are risk factors for development of melanoma EXCEPT
- A. positive family history of melanoma
- B. dark-skinned child
- C. hairy nevus
- D. dysplastic nevus
Correct Answer: B
Rationale: Dark-skinned individuals have a lower risk of melanoma.
Constellation of aniridia and hemihypertrophy is strongly associated with increased risk of which of the following tumors?
- A. rhabdomyosarcoma
- B. hepatoblastoma
- C. Wilms tumor
- D. medulloblastoma
Correct Answer: C
Rationale: Aniridia and hemihypertrophy are features of WAGR syndrome, which increases the risk of Wilms tumor.
Neuroblastoma can be associated with paraneoplastic syndromes. All the following features are paraneoplastic EXCEPT
- A. uncontrollable jerking movements
- B. cerebellar ataxia and increased body coordination
- C. unilateral ptosis, myosis, and anhidrosis
- D. profound secretory diarrhea
Correct Answer: B
Rationale: Increased body coordination is not a typical feature of neuroblastoma-associated paraneoplastic syndromes.
The examiner shines a light in the patient's eyes and notes that the pupils are round and constrict from 4 to 2 mm bilaterally. Next, the examiner asks the patient to focus on a far object, then on the examiner's finger as it is brought from 3 feet distance to 5 inches distance. The pupils constrict bilaterally and the eyes turn inward. Which of the ff. would be the correct documentation of these findings?
- A. Pupils 2 mm
- B. PERRLA
- C. Pupils constricted
- D. Pupils normal
Correct Answer: B
Rationale: PERRLA stands for Pupils Equal Round Reactive to Light and Accommodation. This acronym is used to document the findings seen during a neurological examination of the pupils.