Nokea
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 3-year-old with a head injury should be monitored for
- A. Pupil response
- B. Breathing
- C. Consciousness
- D. All of the above
Correct Answer: D
Rationale: All D assess head injury, per document p47, 0.
A nurse is providing parental instruction for a 24-hour urine collection for a hospitalized child. Which of the following statements by the child's parent needs further instruction?
- A. This test is to evaluate kidney function.'
- B. This test is timed with the first urine collection.'
- C. This container can be kept in the unit refrigerator.'
- D. The container comes from the laboratory.'
Correct Answer: C
Rationale: Urine collection containers should be kept cool but not in a shared refrigerator due to contamination risks; a specific cooler is used, indicating a need for clarification.
The nurse prepares a child to receive oxygen via a tent delivery system by allowing the child to place a teddy bear in and out of the tent and then rewarding the child with a sticker. Which practice is the nurse using?
- A. Therapeutic play
- B. Therapeutic rewards
- C. Therapeutic interventions
- D. Therapeutic communication
Correct Answer: A
Rationale: Using a teddy bear to familiarize the child with the oxygen tent is therapeutic play, reducing fear through familiar objects.
A 3-month-old infant presents with poor feeding and lethargy. Labs show hypoglycemia and ketosis. Most likely diagnosis is:
- A. Sepsis
- B. Glycogen storage disease
- C. Galactosemia
- D. Fatty acid oxidation disorder
Correct Answer: D
Rationale: FAOD causes hypoglycemia and ketosis, per NORD. A-C, E differ.
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.