Nokea
A mother brings her child into the pediatrician's office for a follow up appointment and voices concern that her child has started urinating more frequently and is constantly hungry and thirsty. The nurse suspects:
- A. Hypoglycemia
- B. Huntington disease
- C. Diabetes mellitus
- D. Phenylketonuria
Correct Answer: C
Rationale: The correct answer is C: Diabetes mellitus. The symptoms of increased urination, hunger, and thirst are classic signs of diabetes mellitus. In diabetes, the body cannot properly regulate blood sugar levels, leading to excessive urination (as the body tries to get rid of excess sugar), increased hunger (as cells are not getting enough glucose for energy), and increased thirst (due to dehydration from frequent urination). Hypoglycemia (choice A) would present with low blood sugar symptoms, not high blood sugar symptoms. Huntington disease (choice B) is a genetic disorder affecting the brain, not related to the symptoms described. Phenylketonuria (choice D) is a metabolic disorder related to the inability to break down phenylalanine, not associated with the symptoms described.
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A nurse is caring for a school-age child who is postoperative and received morphine via IV bolus for pain 10 min ago. Which of the following findings is the nurse's priority?
- A. Constipation
- B. Sedation
- C. Bradypnea
- D. Euphoria
Correct Answer: C
Rationale: The correct answer is C: Bradypnea. This is the priority finding because morphine, an opioid, can cause respiratory depression leading to bradypnea or slow breathing. Monitoring the child's respiratory status is crucial to prevent respiratory compromise or arrest. A: Constipation is a common side effect but not an immediate concern. B: Sedation is expected after receiving morphine but not as critical as respiratory depression. D: Euphoria is a possible side effect but not as concerning as respiratory depression. Thus, the priority is to monitor for signs of respiratory depression to ensure the child's safety.
Which is descriptive of attention deficit hyperactivity disorder (ADHD)?
- A. Manifestations of ADHD are typically so bizarre that the diagnosis is easy
- B. Manifestations of ADHD affect all aspects of the child's life but are most obvious in the classroom
- C. Manifestations of ADHD such as learning disabilities eventually disappear by adulthood
- D. Manifestations of ADHD must always be present and are required to receive a positive diagnosis
Correct Answer: B
Rationale: Correct Answer: B
Rationale: Manifestations of ADHD affect all aspects of the child's life but are most obvious in the classroom. ADHD symptoms impact academic performance, social interactions, and behavior in various settings. Children with ADHD often struggle with impulse control, hyperactivity, and inattention, leading to challenges in the classroom environment. This choice acknowledges the pervasive nature of ADHD symptoms while highlighting the prominent impact on the child's educational experience.
Summary of other choices:
A: Incorrect - Manifestations of ADHD are not necessarily bizarre, and the diagnosis is often complex due to overlapping symptoms with other conditions.
C: Incorrect - Learning disabilities and ADHD are separate conditions, and ADHD symptoms may persist into adulthood without necessarily disappearing.
D: Incorrect - While consistent manifestations are a key diagnostic criterion, ADHD symptoms can fluctuate in intensity and may still be present without being constant.
When preparing your pediatric patient for his cardiac assessment, which element would you start with for the assessment?
- A. Assess peripheral pulses
- B. Auscultate heart rate and rhythm
- C. Evaluate chest rise
- D. Palpate liver margins
Correct Answer: B
Rationale: The correct answer is B: Auscultate heart rate and rhythm. This is the first step in a pediatric cardiac assessment because it provides crucial information about the heart's function. Listening to the heart helps identify any abnormalities in heart sounds, such as murmurs or irregular rhythms, which can indicate underlying cardiac issues. Assessing peripheral pulses (choice A) may be important but comes after evaluating the heart. Evaluating chest rise (choice C) is important for respiratory assessment, not specifically for cardiac assessment. Palpating liver margins (choice D) is more relevant for assessing hepatomegaly, not typically the initial step in a cardiac assessment.
A nurse is caring for an adolescent with a closed femur fracture who also has HIV. What type of precautions should the nurse institute?
- A. The patient should be placed on neutropenic precautions due to the risk of osteomyelitis
- B. The patient should be placed on standard precautions to diminish the risk of HIV transmission
- C. The patient should be placed on contact precautions to prevent contact with blood or bloody fluid
- D. The patient should be placed on isolation once the HIV status is suspected
Correct Answer: B
Rationale: The correct answer is B: The patient should be placed on standard precautions to diminish the risk of HIV transmission. Standard precautions are used for all patients to prevent the transmission of infection. In this case, the adolescent has a closed femur fracture and HIV, so the nurse should follow standard precautions, which include hand hygiene, wearing gloves, and using personal protective equipment as needed. Neutropenic precautions (choice A) are not necessary unless the patient has a low white blood cell count. Contact precautions (choice C) are used for specific infections that are spread by direct contact with the patient or their environment. Isolation (choice D) is not required solely based on HIV status.
An 18-month-old patient with Down's Syndrome has a history of mild pulmonary hypertension which requires a daily dose of Furosemide (Lasix). The mother is questioning if the new dose is correct after an adjustment at the child's last Cardiology visit. The child weighs 22 pounds and the dosing for furosemide (Lasix) for this child 2mg/kg/dose. What is the appropriate dose of Furosemide Lasix for this child?
- A. 44 mg/dose
- B. 28 mg/dose
- C. 20 mg/dose
- D. 10 mg/dose
Correct Answer: C
Rationale: The correct dose of Furosemide (Lasix) for this child is 20 mg/dose. To calculate the appropriate dose, we first convert the child's weight from pounds to kilograms (22 lbs ÷ 2.2 = 10 kg). Then, we multiply the weight by the recommended dose of 2 mg/kg (10 kg x 2 mg/kg = 20 mg/dose). This calculation ensures proper dosing based on the child's weight. Choices A, B, and D are incorrect because they do not reflect the correct dosage calculation based on the child's weight.