Nokea
A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain?
- A. This cannot be prevented.
- B. Infants do not feel pain as adults do.
- C. This is not a good reason for refusing immunizations.
- D. A topical anesthetic, EMLA, can be applied before injections are given.
Correct Answer: D
Rationale: The nurse should explain to the mother that a topical anesthetic, such as EMLA cream, can be applied before the infant receives injections to help minimize discomfort. This option addresses the mother's concern about injection-related discomfort while still prioritizing the importance of immunizations for the infant's health. It provides a practical solution that allows the infant to receive the necessary vaccines without experiencing excessive pain or discomfort.
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A 13-year-old adolescent female attained out-patient department (OPD), with a complaint of feeling fat especially over the stomach and thighs; she is also feeling cold, tired, weak, and lacking energy. Examination reveals heart rate 46 beats/min, blood pressure 70/40 mmHg, weight below 3rd centile, dry skin, and lanugo-type hair growth on face; lab investigations show hypokalemia and hypophosphatemia. Of the following, the MOST appropriate next action is
- A. admission to the hospital
- B. referral to psychiatrist
- C. referral to dietician
- D. make an scheduled OP visit to you and to psychiatrist
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Tumor lysis syndrome is a common complication during treatment of pediatric malignancies. Which malignancy is more likely to manifest such complication?
- A. acute myelogenous leukemia (AML)
- B. nephroblastoma
- C. neuroblastoma
- D. Burkitt lymphoma
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Emil, just had a thyroidectomy this morning. Upon awakening, he complains of circumoral tingling, has a positive Chvostek's sign and positive Trousseau's sign. Nurse Ofel assesses this to be an indication of:
- A. Overstimulation of the parathyroid hormone
- B. Insufficient iodine intake
- C. inadvertent removal of the parathyroid
- D. Overuse of radioactive iodine gland
Correct Answer: A
Rationale: The symptoms Emil is experiencing, such as circumoral tingling, positive Chvostek's sign (facial muscle spasm when the facial nerve is tapped), and positive Trousseau's sign (carpal spasm when a blood pressure cuff is inflated), are characteristic signs of hypocalcemia. Hypocalcemia commonly occurs after thyroidectomy due to inadvertent damage or removal of the parathyroid glands. These glands regulate calcium levels in the body by secreting parathyroid hormone (PTH). Therefore, the symptoms Emil is exhibiting are likely due to the overstimulation of the parathyroid hormone in response to decreased calcium levels after the thyroidectomy. Insufficient iodine intake or overuse of radioactive iodine gland would not be the most likely explanations for his symptoms.
All the following are recognized features of 'well-controlled' asthma in a 7-year-old boy EXCEPT
- A. FEV1/FVC ratio >80%
- B. FEV1 >80% of predicted
- C. daytime symptoms ≤2 days/week
- D. 2-4 exacerbations in the past year
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A child has just been unexpectedly admitted to the intensive care unit after abdominal surgery. The nursing staff has completed the admission process, and the child's condition is beginning to stabilize. When speaking with the parents, the nurses should expect which stressors to be evident? (Select all that apply.)
- A. Unfamiliar environment
- B. Usual day-night routine
- C. Strange smells
- D. Provision of privacy
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.