Burns Pediatric Primary Care 7th Edition Test Bank

Burns Pediatric Primary Care 7th Edition Test Bank Related

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A client diagnosed with systemic lupus erythematosus (SLE) comes to the emergency department with severe back pain. She reports that she first felt pain after manually opening her garage door and that she is taking prednisone daily. When adverse effect of long-term corticosteroid therapy is most likely responsible for the pain?

  • A. Hypertension
  • B. Muscle wasting
  • C. Osteoporosis
  • D. Truncal obesity
Correct Answer: C

Rationale: Osteoporosis is the most likely adverse effect of long-term corticosteroid therapy responsible for the severe back pain experienced by the client with systemic lupus erythematosus (SLE). Corticosteroids such as prednisone can lead to bone resorption and calcium loss, resulting in weakened bones and increased risk of fractures. Back pain in this case could be a sign of vertebral compression fractures due to osteoporosis induced by prolonged corticosteroid use. It is important for healthcare providers to monitor bone health in patients on long-term corticosteroid therapy and consider strategies to prevent or manage osteoporosis.

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Choose the condition that exhibits blood values with a low pH and a high PCO :

  • A. Respiratory acidosis
  • B. Metabolic acidosis
  • C. Respiratory alkalosis
  • D. Metaboliâ‚‚c alkalosis
Correct Answer: A

Rationale: Respiratory acidosis is a condition characterized by elevated levels of carbon dioxide (high PCOâ‚‚) and decreased blood pH (low pH) due to inadequate ventilation leading to the accumulation of carbon dioxide in the body. The excess carbon dioxide reacts with water in the blood to form carbonic acid, resulting in a decrease in pH. This is in contrast to metabolic acidosis, which is characterized by an accumulation of acids other than carbon dioxide, leading to a low blood pH. Respiratory alkalosis would present with a low PCOâ‚‚ and high pH, while metabolic alkalosis features a high pH and elevated bicarbonate levels due to non-respiratory causes.

Assume you are evaluating the specificity of the indirect fluorescence antibody test for rapid diagnosis of Campylobacter enteritis. The number of normal persons tested is 150 and the test is positive in 30 persons. The specificity of this test is

  • A. 20%
  • B. 40%
  • C. 60%
  • D. 80%
Correct Answer: D

Rationale: Specificity = (True negatives / Total normals) * 100 = [(150 - 30) / 150] * 100 = 80%.

A young couple of a 2-month-old baby girl with excessive crying seeks medical advice. The LEAST important advice is to

  • A. master the situation in a relaxed manner
  • B. adhere to precry cues
  • C. change milk formula
  • D. avoid sensory overstimulation
Correct Answer: C

Rationale: Changing the milk formula is less critical unless there is evidence of intolerance or allergy.

Which of the following BP changes alerts the nurse to increasing ICP, and should be reported immediately?

  • A. Gradual increase
  • B. Widening pulse pressure
  • C. Rapid drop followed by gradual increase
  • D. Rapid fluctuations
Correct Answer: B

Rationale: Widening pulse pressure is indicative of increasing intracranial pressure (ICP) and must be reported immediately. Pulse pressure is calculated by subtracting the diastolic blood pressure from the systolic blood pressure. An increasing pulse pressure can suggest a rise in ICP due to factors like cerebral edema or hemorrhage. This change indicates increased pressure exerted on blood vessels within the brain, potentially leading to serious consequences like brain herniation. Thus, recognizing and promptly reporting a widening pulse pressure is crucial to prevent further complications and enable appropriate interventions for the patient.

During the physical assessment, the nurse recalls that the areas most frequently affected by multiple sclerosis are the:

  • A. Lateral, 3rd and 4th ventricles
  • B. Pons medulla and cerebral peduncles
  • C. Optic nerve and chiasm
  • D. Above areas
Correct Answer: C

Rationale: Multiple sclerosis (MS) is a disease that primarily affects the central nervous system (CNS) by causing inflammation, damage, and scarring in the myelin sheath that covers nerve fibers. The optic nerve and chiasm are common areas affected by MS, leading to symptoms such as blurred or double vision, loss of color vision, and pain with eye movement. This involvement is known as optic neuritis, a common early symptom of MS. While MS can affect various parts of the CNS, the optic nerve and chiasm are among the most frequently involved areas, making choice C the correct answer in this case.

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