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A newborn appears with abdominal distension and bilious vomiting. Abdominal x-ray reveals a double bubble sign. Most likely diagnosis is:
- A. Pyloric stenosis
- B. Duodenal atresia
- C. Hirschsprung disease
- D. Meconium ileus
Correct Answer: B
Rationale: Duodenal atresia shows a double bubble sign with bilious vomiting, per AAP. A, C-E have different presentations.
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The nurse prepares a child to receive oxygen via a tent delivery system by allowing the child to place a teddy bear in and out of the tent and then rewarding the child with a sticker. Which practice is the nurse using?
- A. Therapeutic play
- B. Therapeutic rewards
- C. Therapeutic interventions
- D. Therapeutic communication
Correct Answer: A
Rationale: Using a teddy bear to familiarize the child with the oxygen tent is therapeutic play, reducing fear through familiar objects.
Most common cause of Cushing syndrome in children is:
- A. Adrenal tumor
- B. Pituitary adenoma
- C. Exogenous steroids
- D. Ectopic ACTH syndrome
Correct Answer: C
Rationale: Exogenous steroids are the most common cause of Cushing syndrome in children, per AAP (doc p150, Q590).
A 6-month-old infant presents with wheezing and retractions. Chest x-ray shows hyperinflation. Most likely diagnosis is:
- A. Pneumonia
- B. Bronchiolitis
- C. Cystic fibrosis
- D. Asthma
Correct Answer: B
Rationale: Bronchiolitis features wheezing and hyperinflation, per AAP. A, C-E differ.
A 4-year-old girl presents with fever and conjunctivitis. Exam shows a rash and swollen hands. Most likely diagnosis is:
- A. Measles
- B. Kawasaki disease
- C. Scarlet fever
- D. Rubella
Correct Answer: B
Rationale: Kawasaki disease includes fever, conjunctivitis, rash, and swollen hands, per AHA. A, C-E differ.
A child with a history of cystic fibrosis suddenly develops right-sided chest pain and shortness of breath. Physical examination reveals decreased breath sounds on the right side and mediastinal shift to the left side. Most likely diagnosis is:
- A. Pneumonia
- B. Asthma exacerbation
- C. Foreign body aspiration
- D. Pneumothorax
Correct Answer: D
Rationale: Pneumothorax matches unilateral findings and mediastinal shift in cystic fibrosis, per CFF. A-C, E don’t fit.