Nokea
A child with nephrotic syndrome requires
- A. High-protein diet
- B. Low-salt diet
- C. Steroids
- D. All of the above
Correct Answer: D
Rationale: All D manage nephrotic syndrome, per document p60, 3.
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The nurse is explaining to a 17-year-old female the actions to prevent urinary tract infection. The nurse determines the adolescent understands the information when she says a good drink to keep urine acidic is:
- A. Milk
- B. Grape juice
- C. Apple juice
- D. Orange juice
Correct Answer: C
Rationale: Apple juice (C) acidifies urine, deterring UTIs. Milk (A) is neutral, grape (B) less effective, and orange (D) is acidic but less cited. Document: 'Juices such as apple or cranberry help maintain acidity of urine.'
A 3-year-old girl presents with recurrent ear infections and speech delay. Audiometry shows conductive hearing loss. Most likely diagnosis is:
- A. Sensorineural hearing loss
- B. Otitis media with effusion
- C. Cholesteatoma
- D. Mastoiditis
Correct Answer: B
Rationale: OME causes conductive loss post-infections, per AAP. A, C-E differ.
A 3-month-old infant presents with poor feeding and lethargy. Labs show hypoglycemia and lactic acidosis. Most likely diagnosis is:
- A. Sepsis
- B. Glycogen storage disease
- C. Galactosemia
- D. Fatty acid oxidation disorder
Correct Answer: D
Rationale: FAOD causes hypoglycemia and lactic acidosis, per NORD. A-C, E differ.
Immediate priority for a 6-year-old with pneumonia is
- A. Nutrition
- B. Medication
- C. Reassurance
- D. Rest
Correct Answer: D
Rationale: Rest D reduces respiratory demand, per document p18, 4.
What is the most likely cause of her pancreatitis?
- A. Bile duct adenoma
- B. Choledochal cyst
- C. Neonatal sclerosing cholangitis
- D. Sphincter of Oddi dysfunction
Correct Answer: B
Rationale: A 2-year-old with acute abdominal pain and pancreatitis, with ultrasound showing a significantly dilated common bile duct tapering distally and dilated intrahepatic ducts, suggests a structural anomaly. Choledochal cyst (Choice B) is a congenital dilatation of the bile ducts, often presenting in young children with pancreatitis, jaundice, or abdominal pain due to bile stasis or obstruction. Bile duct adenoma (Choice A) is a benign tumor, rare in children, and typically asymptomatic unless obstructive, which doesn’t align with the ultrasound findings. Neonatal sclerosing cholangitis (Choice C) is a rare progressive disease usually presenting in infancy with cholestasis, not typically acute pancreatitis or this ultrasound pattern. Sphincter of Oddi dysfunction (Choice D) causes biliary or pancreatic obstruction in adults but is uncommon in children and lacks the structural ductal dilatation seen here. Thus, Choledochal cyst is the most likely cause.