Nokea
A 15-month-old toddler was able to do all the following EXCEPT
- A. walks alone
- B. makes tower of 3 cubes
- C. inserts raisin in a bottle
- D. responds to his/her name
Correct Answer: D
Rationale: Responding to name usually occurs earlier, around 6-9 months.
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Children with ALL who carry poor outcome include all the following EXCEPT
- A. age younger than 1 year and older than 10 year
- B. T-cell immunophenotype
- C. hyperdiploidy chromosomal abnormality
- D. initial leukocyte count of > 50,000
Correct Answer: C
Rationale: Hyperdiploidy is generally associated with a favorable prognosis in ALL, unlike other listed factors.
Parents have a concern that their child is depressed. The nurse relates that which characteristic best describes children with depression?
- A. Increased range of affective response
- B. Preoccupation with need to perform well in school
- C. Change in appetite, resulting in weight loss or gain
- D. Tendency to prefer play instead of schoolwork
Correct Answer: C
Rationale: Change in appetite, resulting in weight loss or gain, is a common characteristic seen in children with depression. Some children may experience a significant decrease in appetite, leading to weight loss, while others may have an increased appetite, resulting in weight gain. This change in eating habits is often a noticeable sign that may indicate the presence of depression in children. It is important for parents and caregivers to be aware of any significant changes in a child's eating patterns and behavior, as it could be a potential indicator of underlying mental health issues such as depression.
You are assigned to evaluate the outcome of fecal occult blood test as a screening test for patients with bowel cancer. The total number of patients who underwent the test is 2030; in those whom the disease is confirmed are 30. The results of fecal occult blood test are as follows: in 20 patients who has a confirmed bowel cancer (truly positive), and in 180 patients who don't have the disease (falsely positive); in 10 patients who truly has the disease (falsely negative), and in 1820 patients who are not affected by the disease (truly negative). All the following statements are true EXCEPT
- A. the prevalence of the disease for those population is 1.48%
- B. the sensitivity of the test is 67%
- C. the specificity of the test is 91%
- D. the positive predictive value is 20%
Correct Answer: A
Rationale: Prevalence = (Total cases / Total population) * 100 = (30 / 2030) * 100 ≈ 1.48%. This statement is correct, so it is the exception as the question asks for the incorrect statement.
A 14-year-old boy and his parents are concerned about bilateral breast enlargement. The nurse's discussion of this should be based on which statement?
- A. This is usually benign and temporary.
- B. This is usually caused by Klinefelter syndrome.
- C. Administration of estrogen effectively reduces gynecomastia.
- D. Administration of testosterone effectively reduces gynecomastia.
Correct Answer: A
Rationale: The correct statement is that bilateral breast enlargement in a 14-year-old boy is usually benign and temporary. This condition, known as gynecomastia, is commonly seen during puberty due to hormonal changes. It typically resolves on its own without the need for intervention. It is important for the nurse to reassure the boy and his parents that this is a normal occurrence and should not be a cause for major concern. It is crucial to address any underlying anxieties and provide education on the natural course of puberty-related changes.
An 8-day-old is admitted with vomiting and dehydration. His HR is 170, RR is 44, BP is 85/52, and T is 99°F. The parents ask if these vital signs are normal. Which is the best response?
- A. The BP is elevated.
- B. The temperature is elevated.
- C. The heart rate is elevated; normal for a neonate is 90-160 bpm.
- D. The respiratory rate is elevated.
Correct Answer: C
Rationale: A neonatal heart rate of 170 is above the normal range (90-160 bpm), which is concerning for dehydration.