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A child is diagnosed with hypoalbuminemia. Her total serum calcium level is normal. Most likely associated finding that may be missed is:
- A. Hypocalcemia
- B. Hypercalcuria
- C. Hypomagnesemia
- D. Hypercalcemia
Correct Answer: D
Rationale: Hypoalbuminemia lowers bound calcium; a normal total calcium suggests hypercalcemia in ionized form, often missed (UpToDate). A-C, E don’t fit.
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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, .
When a parent asks the nurse to describe what is meant by a 'learning disability,' the nurse's most helpful response would be:
- A. It is characterized by inattention, impulsiveness, and hyperactivity'
- B. A child may have difficulty with perception, language, comprehension, or memory'
- C. The child's intellectual ability limits his learning'
- D. The child has difficulty learning because of brain damage'
Correct Answer: B
Rationale: A learning disability (B) involves challenges in perception, language, or comprehension despite normal intelligence. A describes ADHD, C implies low IQ, and D suggests injury, not typical. Document: 'Children with learning disabilities may have… difficulties in perception, language, comprehension.'
Which drug will you prepare for a child with convulsions in the ER?
- A. Ampicillin
- B. Chloroquine
- C. Hydrocortisone
- D. Phenobarbital
Correct Answer: D
Rationale: Phenobarbital D is the anticonvulsant for seizures, per document 6.
A 6-month-old infant presents with wheezing and tachypnea. Chest x-ray shows perihilar infiltrates. Most likely diagnosis is:
- A. Pneumonia
- B. Bronchiolitis
- C. Cystic fibrosis
- D. Asthma
Correct Answer: B
Rationale: Bronchiolitis features wheezing and perihilar infiltrates, per AAP. A, C-E differ.
A one-year-old girl with dysentery is discharged. The most important information for the mother is
- A. Place child on NPO for 8 hours if diarrhea occurs
- B. Don’t wait long before bringing child to hospital
- C. Observe good hygiene to reduce faeco-oral spread
- D. Start anti-diarrhea meds before hospital
Correct Answer: C
Rationale: Hygiene C prevents reinfection, critical in dysentery, per document 0.