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A 4-year-old boy presents with fever, limp, and hip pain. Hip x-ray is normal, but ESR is elevated. Most likely diagnosis is:
- A. Septic arthritis
- B. Transient synovitis
- C. Osteomyelitis
- D. Slipped capital femoral epiphysis
Correct Answer: B
Rationale: Transient synovitis is common in preschoolers with limp and fever, often post-viral, with normal x-ray, per AAP. A, C-E have different presentations or imaging.
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The nurse prepares a child to receive oxygen via a tent delivery system by allowing the child to place a teddy bear in and out of the tent and then rewarding the child with a sticker. Which practice is the nurse using?
- A. Therapeutic play
- B. Therapeutic rewards
- C. Therapeutic interventions
- D. Therapeutic communication
Correct Answer: A
Rationale: Using a teddy bear to familiarize the child with the oxygen tent is therapeutic play, reducing fear through familiar objects.
A 2-year-old with croup requires
- A. Antibiotics
- B. Cool mist
- C. Hot steam
- D. Oxygen therapy
Correct Answer: B
Rationale: Cool mist B relieves croup symptoms, per document p22, 4.
A 5-year-old girl presents with abdominal pain and vomiting. CT shows a twisted mesentery. Most likely diagnosis is:
- A. Appendicitis
- B. Intussusception
- C. Malrotation with volvulus
- D. Meckel diverticulum
Correct Answer: C
Rationale: Malrotation with volvulus features pain, vomiting, and twisted mesentery, per AAP. A, B, D, E differ in CT.
Immediate priority for a 6-year-old with pneumonia is
- A. Nutrition
- B. Medication
- C. Reassurance
- D. Rest
Correct Answer: D
Rationale: Rest D reduces respiratory demand, per document p18, 4.
A newborn girl appears with ambiguous genitalia and a 46,XX karyotype. Labs reveal elevated 17-hydroxyprogesterone. Most likely diagnosis is:
- A. Congenital adrenal hyperplasia
- B. Androgen insensitivity syndrome
- C. Gonadal dysgenesis
- D. 5-alpha reductase deficiency
Correct Answer: A
Rationale: CAH fits XX karyotype and elevated 17-OHP, per AAP (doc p149, Q574).