RN Nursing Care of Children Online Practice 2019 A

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A four-year-old boy is admitted to the hospital with leg pain and fever. He is pale-looking and has bruises over various areas of his body. The physician suspects acute lymphoblastic leukemia (ALL). Which test would be used to confirm the diagnosis?

  • A. Bone marrow aspirate
  • B. Red blood cell count
  • C. Lumbar puncture
  • D. Bone scan
Correct Answer: A

Rationale: A bone marrow aspirate is the definitive test to confirm acute lymphoblastic leukemia (ALL) in this case. It allows for the examination of leukemic cells in the bone marrow, providing a direct assessment of the disease. Red blood cell count (Choice B) is not specific for diagnosing leukemia but may show anemia commonly seen in leukemia patients. Lumbar puncture (Choice C) is used to assess central nervous system involvement, not primarily for confirming ALL. Bone scan (Choice D) is not a standard diagnostic test for ALL and is mainly used for evaluating bone metastases in other conditions.

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What is the most critical physiologic change required of newborns at birth?

  • A. Transition from fetal to neonatal breathing
  • B. Body temperature maintenance
  • C. Stabilization of fluid and electrolytes
  • D. Closure of fetal shunts in the heart
Correct Answer: A

Rationale: The correct answer is A: Transition from fetal to neonatal breathing. The onset of breathing is the most immediate and critical physiologic change required for the transition to extrauterine life. Factors that interfere with this normal transition increase fetal asphyxia, which is a condition of hypoxemia, hypercapnia, and acidosis. While body temperature maintenance, stabilization of fluid and electrolytes, and closure of fetal shunts in the heart are crucial changes in the transition to extrauterine life, breathing and the exchange of oxygen for carbon dioxide must take precedence as they are essential for newborn survival.

What is a physical characteristic of infants whose mothers smoked during pregnancy?

  • A. Being large for gestational age
  • B. Growth restriction in weight only
  • C. Preterm but size appropriate for gestational age
  • D. Growth restriction in weight, length, and chest and head circumference
Correct Answer: D

Rationale: The correct answer is D: Growth restriction in weight, length, and chest and head circumference. Infants born to mothers who smoke during pregnancy exhibit growth failure in weight, length, chest, and head circumference. This growth failure is directly related to the number of cigarettes smoked by the mother. Choices A, B, and C are incorrect because infants exposed to maternal smoking do not tend to be large for gestational age, experience growth restriction in weight only, or be preterm but size appropriate for gestational age.

In what condition should the nurse be alert for altered fluid requirements in children? (Select all that apply.)

  • A. Oliguric renal failure
  • B. Increased intracranial pressure
  • C. Mechanical ventilation
  • D. All above
Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

What illnesses does respiratory hygiene and cough etiquette by the Centers for Disease Control and Prevention (CDC) prevent?

  • A. HBV, Hib, and pertussis
  • B. HSV, influenza, and HBV
  • C. RSV, influenza, and adenovirus
  • D. RSV, pertussis, and varicella
Correct Answer: C

Rationale: The correct answer is C: RSV, influenza, and adenovirus. The CDC recommends respiratory hygiene and etiquette to prevent the transmission of respiratory syncytial virus (RSV), influenza, adenovirus, and other droplet-transmitted unknown viruses. Choices A, B, and D are incorrect because HBV, Hib, pertussis, HSV, and varicella are not typically transmitted via droplets but through other modes of transmission.

Ongoing fluid losses can overwhelm the child's ability to compensate, resulting in shock. What early clinical sign precedes shock?

  • A. Tachycardia
  • B. Slow respirations
  • C. Warm, flushed skin
  • D. Decreased blood pressure
Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

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