Nokea
A 5-year-old girl presents with hematuria and hypertension. Ultrasound shows a renal mass. Most likely diagnosis is:
- A. Nephrotic syndrome
- B. Wilms tumor
- C. Polycystic kidney disease
- D. Renal vein thrombosis
Correct Answer: B
Rationale: Wilms tumor presents with hematuria, hypertension, and a renal mass, per NCI. A, C-E have different features.
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Most common complication of untreated congenital adrenal hyperplasia is:
- A. Adrenal crisis
- B. Sexual infantilism
- C. Hirsutism
- D. Precocious puberty
Correct Answer: A
Rationale: Adrenal crisis is the most serious complication of untreated CAH due to cortisol deficiency, per AAP (doc p148, Q558).
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.
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, .
A nurse is caring for a child following surgical removal of a brain tumor. The nurse is monitoring the child and notes that the pulse rate has increased and the blood pressure has dropped significantly. Bloody drainage is also noted on the posterior dressing. The initial nursing action is to:
- A. Recheck the vital signs in 1 hour
- B. Place the child in Trendelenburg's position
- C. Document the findings
- D. Notify the registered nurse (RN)
Correct Answer: D
Rationale: Increased pulse, low BP, and bloody drainage suggest hemorrhage or ICP; notify RN (D) immediately. Waiting (A), Trendelenburg (B), or documenting only (C) delays care. Document: 'Most tumors create increased ICP… [requiring] immediate action.'
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.