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A 14-year-old boy appears with tall stature, long limbs, and a heart murmur. Echocardiogram reveals aortic root dilation. Most likely diagnosis is:
- A. Klinefelter syndrome
- B. Marfan syndrome
- C. Growth hormone excess
- D. Hyperthyroidism
Correct Answer: B
Rationale: Marfan syndrome fits tall stature, long limbs, and aortic dilation, per AAP (doc p151, Q606).
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A child with a history of cystic fibrosis suddenly develops right-sided chest pain and shortness of breath. Physical examination reveals decreased breath sounds on the right side and mediastinal shift to the left side. Most likely diagnosis is:
- A. Pneumonia
- B. Asthma exacerbation
- C. Foreign body aspiration
- D. Pneumothorax
Correct Answer: D
Rationale: Pneumothorax matches unilateral findings and mediastinal shift in cystic fibrosis, per CFF. A-C, E don’t fit.
A nurse is caring for a child following surgical removal of a brain tumor. The nurse is monitoring the child and notes that the pulse rate has increased and the blood pressure has dropped significantly. Bloody drainage is also noted on the posterior dressing. The initial nursing action is to:
- A. Recheck the vital signs in 1 hour
- B. Place the child in Trendelenburg's position
- C. Document the findings
- D. Notify the registered nurse (RN)
Correct Answer: D
Rationale: Increased pulse, low BP, and bloody drainage suggest hemorrhage or ICP; notify RN (D) immediately. Waiting (A), Trendelenburg (B), or documenting only (C) delays care. Document: 'Most tumors create increased ICP… [requiring] immediate action.'
In administering vitamin K to the infant shortly after birth, the nurse understands that vitamin K is
- A. Synthesized by the kidneys
- B. Not initially synthesized because of sterile bowel at birth
- C. Given to enhance lung function
- D. Produced by the liver immediately
Correct Answer: B
Rationale: Not initially synthesized because of sterile bowel at birth B explains the need for vitamin K to prevent hemorrhagic disease, per document .
Most common endocrine abnormality in patients with cystic fibrosis is:
- A. Hypothyroidism
- B. Diabetes mellitus
- C. Adrenal insufficiency
- D. Hyperthyroidism
Correct Answer: B
Rationale: Cystic fibrosis-related diabetes is the most common endocrine issue, from pancreatic damage, per CFF. A, C-E are less frequent.
The responsibility of a mandatory reporter is to:
- A. Report actual abuse to legal authorities
- B. Provide evidence of suspected child abuse to legal authorities
- C. Report actual or suspected abuse to legal authorities
- D. Investigate suspected child abuse
Correct Answer: C
Rationale: Mandatory reporters (e.g., nurses) must report actual or suspected abuse to authorities, as per legal and ethical standards. Reporting only actual abuse misses suspicion, providing evidence exceeds their role, and investigating is for authorities, not reporters.