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A 2-year-old boy presents with fever and a stiff neck. CSF analysis shows gram-positive cocci. Most likely diagnosis is:
- A. Viral meningitis
- B. Streptococcus pneumoniae meningitis
- C. Haemophilus influenzae meningitis
- D. Neisseria meningitidis meningitis
Correct Answer: B
Rationale: S. pneumoniae meningitis is a common cause of bacterial meningitis with gram-positive cocci in CSF, per AAP. A, C-E differ in etiology or CSF findings.
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A 6-month-old infant presents with wheezing and tachypnea. Chest x-ray shows perihilar infiltrates. Most likely diagnosis is:
- A. Pneumonia
- B. Bronchiolitis
- C. Cystic fibrosis
- D. Asthma
Correct Answer: B
Rationale: Bronchiolitis features wheezing and perihilar infiltrates, per AAP. A, C-E differ.
A 2-year-old with croup requires
- A. Antibiotics
- B. Cool mist
- C. Hot steam
- D. Oxygen therapy
Correct Answer: B
Rationale: Cool mist B relieves croup symptoms, per document p22, 4.
Immediate priority for a 6-year-old with pneumonia is
- A. Nutrition
- B. Medication
- C. Reassurance
- D. Rest
Correct Answer: D
Rationale: Rest D reduces respiratory demand, per document p18, 4.
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.'
The best growth chart indicator in patients with acute malnutrition is:
- A. Body mass index (BMI)
- B. Body weight
- C. Weight-for-height
- D. Head circumference
Correct Answer: C
Rationale: Weight-for-height best detects acute malnutrition (wasting), per WHO. BMI is less specific in kids, and B-D assess other aspects.