Nokea
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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In administering vitamin K to the infant shortly after birth, the nurse understands that vitamin K is
- A. Synthesized by the kidneys
- B. Not initially synthesized because of sterile bowel at birth
- C. Given to enhance lung function
- D. Produced by the liver immediately
Correct Answer: B
Rationale: Not initially synthesized because of sterile bowel at birth B explains the need for vitamin K to prevent hemorrhagic disease, per document .
The responsibility of a mandatory reporter is to:
- A. Report actual abuse to legal authorities
- B. Provide evidence of suspected child abuse to legal authorities
- C. Report actual or suspected abuse to legal authorities
- D. Investigate suspected child abuse
Correct Answer: C
Rationale: Mandatory reporters (e.g., nurses) must report actual or suspected abuse to authorities, as per legal and ethical standards. Reporting only actual abuse misses suspicion, providing evidence exceeds their role, and investigating is for authorities, not reporters.
A 19-year-old pregnant mother likes all-night dance parties. She took methylenedioxymetamphetamine (MDMA 'X', Ecstasy) routinely before and during pregnancy. The most likely fetal defect is:
- A. Pulmonary
- B. Gastrointestinal
- C. CNS
- D. Cardiac
Correct Answer: D
Rationale: MDMA use in pregnancy is linked to cardiac defects , like septal defects, per studies (Teratology). A-C, E are less specific.
A 3-year-old with a head injury should be monitored for
- A. Pupil response
- B. Breathing
- C. Consciousness
- D. All of the above
Correct Answer: D
Rationale: All D assess head injury, per document p47, 0.
A newborn appears with abdominal distension and bilious vomiting. Abdominal x-ray reveals a double bubble sign. Most likely diagnosis is:
- A. Pyloric stenosis
- B. Duodenal atresia
- C. Hirschsprung disease
- D. Meconium ileus
Correct Answer: B
Rationale: Duodenal atresia shows a double bubble sign with bilious vomiting, per AAP. A, C-E have different presentations.