Nokea
A 2-year-old child presents with a peeling, erythematous rash on the hands and feet. The mother reports that he has become ill tempered and refuses to walk about, preferring to lie in bed. Physical examination reveals an irritable, pale child with photophobia. Temperature is 98.5°F, heart rate is 80/minute, and respiratory rate is 23/minute. Tremor of the tongue is evident. Further history and follow-up evaluation reveal that the child's elder brothers have been playing with liquid mercury. Which is the most likely diagnosis?
- A. Measles
- B. Fifth disease
- C. Kawasaki disease
- D. Acrodynia
Correct Answer: D
Rationale: Acrodynia, also known as pink disease, is caused by chronic mercury exposure. The symptoms described, including the rash, irritability, photophobia, and tremor, are consistent with mercury poisoning.
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a woman who is pregnant is undergoing an amniocentesis. during the test, elevated levels of AFP are found. this indicate to which of the following conditions :
- A. CP
- B. spina bifida
- C. down syndrome
- D. hydrocephalus
Correct Answer: B
Rationale: Elevated levels of AFP (alpha-fetoprotein) in the amniotic fluid during an amniocentesis often indicate neural tube defects, such as spina bifida. Spina bifida is a condition where the spinal cord does not develop properly, leading to a range of possible issues depending on the severity of the defect. In this case, the elevated AFP levels point towards a higher likelihood of spina bifida rather than other conditions like CP (cerebral palsy), Down syndrome, or hydrocephalus.
A woman delivers a 3,250 g neonate at 42 weeks' gestation. Which physical finding is expected during an examination if this neonate?
- A. Abundant lanugo
- B. Absence of sole creases
- C. Breast bud of 1-2 mm in diameter
- D. Leathery, cracked, and wrinkled skin
Correct Answer: D
Rationale: A neonate born at 42 weeks' gestation, also known as post-term, is expected to have skin that appears leathery, cracked, and wrinkled due to prolonged exposure to the amniotic fluid in utero. This is a common physical finding in post-term neonates due to the decreased amount of vernix caseosa and amniotic fluid present on the skin at birth. Abundant lanugo (fine hair), absence of sole creases, and breast bud development are more commonly seen in preterm or term newborns, rather than post-term newborns.
Which should the nurse consider when preparing a school-age child and the family for heart surgery?
- A. Unfamiliar equipment should not be shown.
- B. Let the child hear the sounds of an ECG monitor.
- C. Avoid mentioning postoperative discomfort and interventions.
- D. Explain that an endotracheal tube will not be needed if the surgery goes well.
Correct Answer: B
Rationale: When preparing a school-age child and the family for heart surgery, it is essential to provide honest and age-appropriate information to help the child feel more comfortable and reduce anxiety. Letting the child hear the sounds of an ECG monitor is beneficial as it allows them to become familiar with medical equipment and procedures, making them less intimidated by the unfamiliar sounds they may encounter during and after surgery. Familiarizing the child with the sounds can also help alleviate fears and promote understanding of what is happening during the procedure. It is important to maintain open communication, address concerns, and prepare the child and family for what to expect before, during, and after surgery.
The LEAST helpful advice for a 10-month-old baby refusing spoon feeding is
- A. respect infant independence
- B. offer softer diet
- C. use 2 spoons (1 for child and 1 for parent)
- D. use finger foods
Correct Answer: B
Rationale: Offering softer diet may not address refusal due to developmental factors.
A patient has orders to receive 1 L (1000 mL) of 5% dextrose and lactated Ringer's solution to be infused over 8 hours. How many millilitres will be infused per hour?
- A. 80
- B. 100
- C. 125
- D. 150
Correct Answer: C
Rationale: The total volume to be infused over 8 hours is 1000 mL. To determine how many millilitres will be infused per hour, you can divide the total volume by the total time: