A child with which of the following diseases may suffer a severe acute reaction to radiotherapy?
- A. Chédiak-Higashi syndrome
- B. Neurofibromatosis
- C. Chronic mucocutaneous candidiasis
- D. Ataxia-telangiectasia
Correct Answer: D
Rationale: Children with ataxia-telangiectasia are highly sensitive to radiation and can suffer severe reactions to radiotherapy.
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The nurse is conducting a staff in-service on childhood-acquired heart diseases. Which is a major clinical manifestation of rheumatic fever?
- A. Polyarthritis
- B. Osler nodes
- C. Janeway spots
- D. Splinter hemorrhages of distal third of nails
Correct Answer: A
Rationale: Rheumatic fever is a systemic inflammatory condition that can develop as a complication of untreated or inadequately treated streptococcal infections, such as strep throat. One of the major clinical manifestations of rheumatic fever is polyarthritis, which is characterized by inflammation and pain in multiple joints. It typically involves large joints like the knees, ankles, elbows, and wrists. Polyarthritis in rheumatic fever is migratory in nature, meaning the joint pain shifts from one joint to another over a period of time. Other common clinical manifestations of rheumatic fever include carditis (inflammation of the heart), chorea (involuntary movements), subcutaneous nodules, and erythema marginatum (rash).
Which of the following is disease process characterized by a chronic progressive inflammation of the sacroiliac and costovertebral joints and adjacent soft tissue?
- A. Rheumatoid arthritis
- B. Scoliosis
- C. Kyphosis
- D. Ankylosing spondylitis
Correct Answer: D
Rationale: Ankylosing spondylitis is a chronic inflammatory disease primarily affecting the sacroiliac joints and the spine. It leads to progressive inflammation of the sacroiliac and costovertebral joints, which can cause pain, stiffness, and eventually lead to fusion of the affected joints. This condition is also characterized by inflammation of other joints, tendons, and ligaments, as well as extra-articular manifestations such as uveitis and cardiac involvement. Ankylosing spondylitis is more common in young males and is associated with the presence of the HLA-B27 genetic marker. It is important to diagnose and manage ankylosing spondylitis early to help prevent complications and improve quality of life for affected individuals.
Following the American Cancer Society guidelines, the nurse should recommend that the women:
- A. Perform breast self-examination annually
- B. Have a physician conduct a clinical
- C. Have a mammogram annually examination every 2 years
- D. Have a normal receptor assay annually
Correct Answer: C
Rationale: The American Cancer Society recommends that women have a mammogram annually, starting at age 45, and then have the option to switch to every two years starting at age 55. This is based on evidence showing that regular mammograms can help detect breast cancer early when it is most treatable. Breast self-examinations are no longer recommended as a routine screening method due to studies showing they do not reduce mortality from breast cancer. Clinical breast exams conducted by a physician are also not recommended for routine screening in average-risk women, as they have not been shown to be effective in reducing breast cancer mortality. Normal receptor assay testing is not a screening test for breast cancer and is used to help determine the best treatment options for diagnosed breast cancer cases.
A worried mother of a 4-year-old boy describing attacks of inconsolable crying episodes. The MOST appropriate action is
- A. reassures her that this is a normal phenomenon of temper tantrum
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate social issues of the family
Correct Answer: A
Rationale: Temper tantrums are common at this age and often do not indicate pathology.
Prenatal changes associated with maternal diabetes include all the following EXCEPT
- A. shorter birth length
- B. lower neonatal neurodevelopmental status
- C. reduced milk production of the most times
- D. increased neonatal learning problems
Correct Answer: C
Rationale: Reduced milk production is not directly associated with maternal diabetes.