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A 3-year-old child from a suburban community presents with vomiting, diarrhea, and blurred vision. Physical examination reveals an afebrile child with pinpoint pupils, salivation, and muscular fasciculations. The child's lawn was treated yesterday for insects. Which of the following tests will establish the correct diagnosis?
- A. Blood-lead level
- B. 24-hour urine mercury level
- C. Plasma cholinesterase level
- D. Urine malathion level
Correct Answer: C
Rationale: The symptoms suggest organophosphate poisoning, which can be confirmed by measuring plasma cholinesterase levels, as organophosphates inhibit this enzyme.
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As the nurse collects data on a patient, which of the following is a symptom that may be found that the patient with anaphylaxis may be experiencing?
- A. Dermatitis
- B. Sinusitis
- C. Delirium
- D. Wheezing
Correct Answer: D
Rationale: Wheezing is a common symptom of anaphylaxis, along with other signs such as difficulty breathing, chest tightness, coughing, and throat swelling. Wheezing is caused by the constriction of the airways due to the body's extreme immune response to the allergen, leading to difficulty in breathing and wheezing sounds during respiration. It is important for healthcare professionals to recognize wheezing as a symptom of anaphylaxis and respond promptly with appropriate interventions, such as administering epinephrine and providing respiratory support.
You are examining an infant with multiple cutaneous hemangiomas; you suspect involvement of internal organs. The MOST common site of visceral involvement by hemangiomas is
- A. brain
- B. heart
- C. lung
- D. liver
Correct Answer: D
Rationale: Liver is the most common site of visceral involvement by hemangiomas.
The nurse assesses for the characteristic movement of Parkinson's disease which is a (n):
- A. Exaggerated muscle flaccidity that leads to frequent falls
- B. Hyperextension of the back and neck that alters normal movements
- C. Pronation- supination of the hand and forearm that interferes with normal hand activities
- D. Combination of all of the above
Correct Answer: D
Rationale: The characteristic movement of Parkinson's disease is the pronation-supination of the hand and forearm, also known as the "pill-rolling" tremor. This movement interferes with normal hand activities and is a common early sign of Parkinson's disease. Exaggerated muscle flaccidity leading to frequent falls and hyperextension of the back and neck are not typically associated with Parkinson's disease.
What is most likely the underlying physiology of primary enuresis?
- A. Psychogenic stress
- B. Delayed bladder maturation
- C. Urinary tract infection
- D. Vesicoureteral reflux
Correct Answer: B
Rationale: Primary enuresis refers to involuntary wetting during sleep in children who have never been consistently dry at night. The most likely underlying physiology of primary enuresis is delayed bladder maturation. This means that the child's bladder is not yet able to hold urine for the entire night, leading to bedwetting episodes. As children age, their bladder capacity increases and their ability to remain dry at night improves. In most cases, primary enuresis resolves on its own as the child's bladder matures. It is important for parents and caregivers to provide support and reassurance to the child during this time.
A teen asks a nurse, "What is physical dependence in substance abuse?" Which is the correct response by the nurse?
- A. Problem that occurs in conjunction with addiction
- B. Involuntary physiologic response to drug
- C. Culturally defined use of drugs for purposes other than accepted medical purposes
- D. Voluntary behavior based on psychosocial needs
Correct Answer: B
Rationale: Physical dependence in substance abuse refers to the body's physiological adaptation to a drug, leading to the development of withdrawal symptoms when the drug is abruptly stopped or reduced in dosage. This is different from addiction, which involves psychological dependence and compulsive drug-seeking behavior despite harmful consequences. Physical dependence is typically characterized by tolerance (needing higher doses to achieve the same effect) and withdrawal symptoms when the drug is stopped.