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A 3-month-old infant presents with tachypnea and poor feeding. Chest x-ray shows cardiomegaly and pulmonary edema. Most likely diagnosis is:
- A. Pneumonia
- B. Congestive heart failure
- C. Bronchiolitis
- D. Cystic fibrosis
Correct Answer: B
Rationale: CHF shows cardiomegaly and edema, per AHA. A, C-E differ.
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A 19-year-old pregnant mother likes all-night dance parties. She took methylenedioxymetamphetamine (MDMA 'X', Ecstasy) routinely before and during pregnancy. The most likely fetal defect is:
- A. Pulmonary
- B. Gastrointestinal
- C. CNS
- D. Cardiac
Correct Answer: D
Rationale: MDMA use in pregnancy is linked to cardiac defects , like septal defects, per studies (Teratology). A-C, E are less specific.
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.
The nurse is caring for a child with suspected diabetes insipidus. Which clinical manifestations would she expect to observe?
- A. Nausea and vomiting
- B. Polyuria and polydipsia
- C. Oliguria and uremia
- D. Glycosuria and hematuria
Correct Answer: B
Rationale: Diabetes insipidus causes polyuria and polydipsia (B) due to lack of antidiuretic hormone. Nausea (A), oliguria (C), and glycosuria (D) are unrelated. Document: 'Excessive urination accompanied by insatiable thirst is the primary clinical manifestation.'
A 3-year-old with a burn should avoid
- A. Breaking blisters
- B. Infection
- C. Pain
- D. Swelling
Correct Answer: A
Rationale: Breaking blisters A increases infection risk, per document p42, 3.
A child with sickle cell disease should avoid
- A. Cold environments
- B. Dehydration
- C. Stress
- D. All of the above
Correct Answer: D
Rationale: All D trigger crises, per document p53, .