Nokea
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 one-year-old girl with dysentery is discharged. The most important information for the mother is
- A. Place child on NPO for 8 hours if diarrhea occurs
- B. Don’t wait long before bringing child to hospital
- C. Observe good hygiene to reduce faeco-oral spread
- D. Start anti-diarrhea meds before hospital
Correct Answer: C
Rationale: Hygiene C prevents reinfection, critical in dysentery, per document 0.
In administering vitamin K to the infant shortly after birth, the nurse understands that vitamin K is
- A. Synthesized by the kidneys
- B. Not initially synthesized because of sterile bowel at birth
- C. Given to enhance lung function
- D. Produced by the liver immediately
Correct Answer: B
Rationale: Not initially synthesized because of sterile bowel at birth B explains the need for vitamin K to prevent hemorrhagic disease, per document .
A physician should be informed if a 7-year-old with a fractured femur in a cast shows
- A. Cast damp and warm after 24 hours
- B. Increased urinary output
- C. Inability to move toes
- D. Pedal pulse of 90 bpm
Correct Answer: C
Rationale: Inability to move toes C suggests circulation issues, per document p11, .
The responsibility of a mandatory reporter is to:
- A. Report actual abuse to legal authorities
- B. Provide evidence of suspected child abuse to legal authorities
- C. Report actual or suspected abuse to legal authorities
- D. Investigate suspected child abuse
Correct Answer: C
Rationale: Mandatory reporters (e.g., nurses) must report actual or suspected abuse to authorities, as per legal and ethical standards. Reporting only actual abuse misses suspicion, providing evidence exceeds their role, and investigating is for authorities, not reporters.
The most common site for temperature in a 2-year-old is
- A. Axillary
- B. Oral
- C. Rectal
- D. Temporal
Correct Answer: A
Rationale: Axillary A is safest for toddlers, per document p34, 4.