Nokea
A 5 years old boy presents with joint swelling after minor trauma, mother gives history of prolonged bleeding from circumcision site. His platelets count is 170000, PT is 10 seconds and APTT is 60 seconds. What is most likely the diagnosis?
- A. Idiopathic thrombocytopenic purpura
- B. Platelets function defect
- C. Von Willebrand disease
- D. Hemophilia
Correct Answer: D
Rationale: Hemophilia is characterized by prolonged APTT with normal platelet count and PT, indicating a coagulation factor deficiency.
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A 10-month-old child can do all the following EXCEPT
- A. says mama or dada
- B. follows one-step command without gesture
- C. points to objects or real first word
- D. speaks inhibition word 'no'
Correct Answer: D
Rationale: Speaking inhibition words like 'no' typically occurs later.
Which patient should be monitored most closely for dehydration?
- A. The 50-year-old with an ileostomy
- B. The 72-year-old with diabetes mellitus
- C. The 19-year-old with chronic asthma
- D. The 28-year-old with a broken femur
Correct Answer: A
Rationale: A patient with an ileostomy has an increased risk of dehydration because the ileostomy bypasses a significant portion of the small intestine where most of the water absorption occurs. As a result, the patient is more likely to experience fluid and electrolyte imbalances, leading to dehydration. It is important to monitor this patient closely for signs and symptoms of dehydration, such as decreased urine output, dry mouth, dark-colored urine, weakness, dizziness, and confusion, and take appropriate measures to ensure adequate hydration.
Of the following, the WORST prognostic factor in pediatric osteosarcoma is
- A. primary pelvic bone tumor
- B. poor histologic response to treatment
- C. bony metastases at the time of diagnosis
- D. lung metastases at the time of diagnosis
Correct Answer: B
Rationale: Poor histologic response to neoadjuvant chemotherapy is a strong predictor of poor prognosis.
In terms of gross motor development, which should the nurse expect a 5-month-old infant to do? (Select all that apply.)
- A. Roll from abdomen to back.
- B. Put feet in mouth when supine.
- C. Roll from back to abdomen.
- D. Sit erect without support.
Correct Answer: A
Rationale: At 5 months old, an infant would typically be able to roll from abdomen to back (Choice A). This is an important gross motor skill that develops during this stage. Additionally, putting their feet in their mouth when lying on their back (Choice B) is also a common movement seen at this age. Both these actions demonstrate the increasing strength and coordination of the infant's muscles as they develop and explore their physical abilities. Rolling from back to abdomen (Choice C) and sitting erect without support (Choice D) typically develop later, around 6-7 months and 8-9 months, respectively. Moving from prone to sitting position (Choice E) and adjusting posture to reach an object (Choice F) are usually mastered around 8-9 months as well.
Katie is admitted to the intensive care unit of Nurseslabs Medical Center for diabetic ketoacidosis; which of the following is of primary importance when caring for the child?
- A. Giving I.V. NPH insulin in high doses
- B. Evaluating the child for cardiac abnormalities
- C. Limiting fluids to prevent aggravating cerebral edema
- D. Monitoring and recording the child's vital signs for hypertension
Correct Answer: B
Rationale: When caring for a child with diabetic ketoacidosis in the intensive care unit, evaluating the child for cardiac abnormalities is of primary importance. Diabetic ketoacidosis can lead to electrolyte imbalances, such as hypokalemia, which can result in cardiac complications, such as arrhythmias and cardiac arrest. Monitoring the child's cardiac function, including obtaining an electrocardiogram (EKG) and assessing for signs of heart failure, is essential in managing and preventing potential cardiac complications in this critical condition. While the other options are important considerations in the care of a child with diabetic ketoacidosis, evaluating the child for cardiac abnormalities takes precedence due to the life-threatening implications of cardiac complications in this setting.