Nokea
A 5-year old girl presents to ER with fever, convulsions and unconsciousness of one day duration. On examination she is pale, Glasgow coma scale is 8 and there are no signs of meningial irritation and no focal neurological signs. The most likely diagnosis is:
- A. Viral encephalitis
- B. Pyomeningitis
- C. Tuberculous meningitis
- D. Cerebral malaria
Correct Answer: D
Rationale: Cerebral malaria can cause fever, seizures, altered consciousness, and normal cerebrospinal fluid findings without focal neurological signs.
You may also like to solve these questions
A nurse has determined that a newborn's respiratory breathing is within a normal range. How should the nurse document this finding?
- A. Irregular, abdominal, 30 to 60 breaths/min
- B. Regular, abdominal, 25 to 35 breaths/min
- C. Regular, noisy, 35 to 45 breaths/min
- D. Irregular, quiet, 45 to 55 breaths/min
Correct Answer: B
Rationale: A newborn with normal respiratory breathing would typically exhibit regular breathing patterns, with abdominal movements indicating effective diaphragmatic breathing. The normal respiratory rate for a newborn is considered to be 25 to 35 breaths per minute. Therefore, documenting the newborn's respiratory breathing as "Regular, abdominal, 25 to 35 breaths/min" would accurately represent a normal finding.
Although melanoma is relatively rare in children, some risk factors may increase its incidence. All the following are risk factors for development of melanoma EXCEPT
- A. positive family history of melanoma
- B. dark-skinned child
- C. hairy nevus
- D. dysplastic nevus
Correct Answer: B
Rationale: Dark-skinned individuals have a lower risk of melanoma.
A hospitalized client has the following blood lab values: WBC 3,000/ul, RBC 5.0 (X 106), platelets 300, 000, what would be a priority nursing intervention?
- A. Preventing infection
- B. Alleviating pain
- C. Controlling infection
- D. Monitoring blood transfusion reactions
Correct Answer: A
Rationale: With a WBC count of 3,000/ul (indicating leukopenia or low white blood cell count), the priority nursing intervention should be preventing infection. Leukopenia puts the client at a higher risk of developing infections due to a compromised immune system. Nurses should focus on implementing strict infection control measures, such as hand hygiene, maintaining a sterile environment, and promoting vaccination compliance to reduce the risk of infection for the hospitalized client. This intervention is crucial for ensuring the client's safety and well-being during their hospital stay. Alleviating pain, controlling infection, and monitoring blood transfusion reactions are important aspects of care but in this scenario, preventing infection takes precedence due to the client's low WBC count.
The nurse is conducting a staff in-service on childhood-acquired heart diseases. Which is a major clinical manifestation of rheumatic fever?
- A. Polyarthritis
- B. Osler nodes
- C. Janeway spots
- D. Splinter hemorrhages of distal third of nails
Correct Answer: A
Rationale: Rheumatic fever is a systemic inflammatory condition that can develop as a complication of untreated or inadequately treated streptococcal infections, such as strep throat. One of the major clinical manifestations of rheumatic fever is polyarthritis, which is characterized by inflammation and pain in multiple joints. It typically involves large joints like the knees, ankles, elbows, and wrists. Polyarthritis in rheumatic fever is migratory in nature, meaning the joint pain shifts from one joint to another over a period of time. Other common clinical manifestations of rheumatic fever include carditis (inflammation of the heart), chorea (involuntary movements), subcutaneous nodules, and erythema marginatum (rash).
Nurse Melanie is teaching an adult class about the different types of hepatitis. Which statement does not pertain to hepatitis A?
- A. "Is caused by an RNA virus of the enterovirus family."
- B. "It spreads primarily by fecal-oral route, usually through the ingestion of infcetd food or liquids."
- C. "It may not be spread from sexual contact."
- D. "Type A hepatitis occurs worldwide, especially in areas with overcrowding and poor sanitation."
Correct Answer: A
Rationale: Statement A is incorrect because hepatitis A is not caused by an RNA virus of the enterovirus family. Instead, hepatitis A is caused by the hepatitis A virus (HAV), which belongs to the Picornaviridae family. Hepatitis A is primarily spread through the fecal-oral route, usually through the ingestion of contaminated food or water. Additionally, hepatitis A can be transmitted through close personal contact and sexual contact. While hepatitis A occurs worldwide, it is more prevalent in areas with poor sanitation and overcrowding.