Nokea
A 5-year-old child, recently diagnosed with ileocecal Burkitt lymphoma; lab investigations reveal: serum uric acid 12 mg/dl, serum sodium, 145 meq/dl; serum potassium, 4.5 meq/dl; serum phosphate 4.4 meq/dl; serum calcium, 8.9 mg/dl; blood urea, 22 mg/dl; serum creatinine, 0.8 mg/dl. Of the following, the MOST effective treatment is
- A. excessive hydration
- B. sodium bicarbonate
- C. xanthine oxidase inhibitor
- D. recombinant urate oxidase
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A 5-year-old boy is one of the shortest in class. His father is 6' tall and his mother 5'7'. What should the nurse tell his mother?
- A. He is expected to grow about 3 inches per year from ages 6 to 9.
- B. He is expected to grow about 2 inches per year from ages 6 to 9.
- C. He should be evaluated by an endocrinologist for growth hormone injections.
- D. His growth will be re-evaluated when he is 7 years old.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition?
- A. Hypertension
- B. Edema
- C. Diabetes insipidus
- D. Protection against postmenopausal osteoporosis
Correct Answer: A
Rationale: Hydrochlorothiazide is primarily indicated for hypertension (HTN). Thiazides like hydrochlorothiazide are commonly the first-line treatment for hypertension. While hydrochlorothiazide can be used for edema, diabetes insipidus, and postmenopausal osteoporosis to some extent, its main use and efficacy lie in managing hypertension.
The nurse is reviewing the prescriber’s orders and notes that omeprazole has been order for a patient admitted with acute coronary syndrome (ACS). The nurse should be concerned if this medication is combined with which medication noted on the patient’s record.
- A. Aspirin 81mg daily
- B. Clopidogrel (Plavix) 75mg daily
- C. Heparin 5000 units subQ q12hrs
- D. Metoprolol 50mg q8hrs
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Normal values (reference intervals) are difficult to establish within the pediatric population. Many variables should be considered when developing reference intervals. All the following are variables that commonly considered to define reference intervals EXCEPT
- A. genetic composition
- B. physiologic development
- C. environmental influences
- D. subclinical disease
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
In an immunization clinic, which patient will the nurse identify as not eligible to receive routine immunizations?
- A. An 8-year-old experiencing diarrhea
- B. A 2-year-old with a history of pre-term birth
- C. A 4-year-old with a fever and upper respiratory tract infection
- D. A 6-year-old who has been recently exposed to a classmate with chickenpox
Correct Answer: C
Rationale: The nurse should identify the 4-year-old with a fever and upper respiratory tract infection as not eligible to receive routine immunizations. It is contraindicated to administer vaccines in the presence of moderate to severe illness, whether with or without fever, to prevent potential complications or reduced vaccine efficacy.