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.
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When a parent asks the nurse to describe what is meant by a 'learning disability,' the nurse's most helpful response would be:
- A. It is characterized by inattention, impulsiveness, and hyperactivity'
- B. A child may have difficulty with perception, language, comprehension, or memory'
- C. The child's intellectual ability limits his learning'
- D. The child has difficulty learning because of brain damage'
Correct Answer: B
Rationale: A learning disability (B) involves challenges in perception, language, or comprehension despite normal intelligence. A describes ADHD, C implies low IQ, and D suggests injury, not typical. Document: 'Children with learning disabilities may have… difficulties in perception, language, comprehension.'
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.'
A 3-month-old infant presents with poor feeding and hypotonia. MRI shows periventricular leukomalacia. Most likely diagnosis is:
- A. Hypoxic-ischemic encephalopathy
- B. Congenital infection
- C. Metabolic disorder
- D. Trauma
Correct Answer: A
Rationale: HIE causes leukomalacia, per AAP. B-E differ.
In fetal circulation, the pressure is greatest in the
- A. Left ventricle
- B. Right atrium
- C. Pulmonary artery
- D. Aorta
Correct Answer: B
Rationale: Right atrium B has the highest pressure in fetal circulation due to venous return, per document 3.
A 6-month-old infant presents with wheezing and retractions. Chest x-ray shows hyperinflation. Most likely diagnosis is:
- A. Pneumonia
- B. Bronchiolitis
- C. Cystic fibrosis
- D. Asthma
Correct Answer: B
Rationale: Bronchiolitis features wheezing and hyperinflation, per AAP. A, C-E differ.