Nokea
A nurse in the emergency department is assessing a 5-year-old child with symptoms of pneumonia and a fever of 102° F. Which intervention can the nurse implement to promote a sense of control for the child?
- A. None; this is an emergency and the child should not participate in care.
- B. Allow the child to hold the digital thermometer while taking the child's blood pressure.
- C. Ask the child if it is OK to take a temperature in the ear.
- D. Have parents wait in the waiting room.
Correct Answer: C
Rationale: Involving the child in decision-making and asking for their permission before performing a procedure promotes a sense of control and autonomy. By asking the child if it is OK to take the temperature in the ear, the nurse respects the child's preferences and helps them feel more empowered in the situation. This fosters a positive therapeutic relationship and can help reduce the child's anxiety during the medical assessment.
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When a neurologist asks a patient to smile, which cranial nerve is being tested?
- A. CN II
- B. CN X
- C. CN VII
- D. CN XI
Correct Answer: C
Rationale: When a neurologist asks a patient to smile, they are testing the function of the facial nerve, Cranial Nerve VII (CN VII). CN VII controls the muscles of facial expression, including the muscles required for smiling. If there is weakness or paralysis on one side of the face when the patient tries to smile, it may indicate a problem with CN VII function, such as Bell's palsy or a lesion affecting the facial nerve.
An infant with bladder exstrophy has had a continent urinary reservoir placed. Which discharge instruction should be included?
- A. Allow your child to sleep on the abdomen for comfort.
- B. Avoid contact with latex-containing surfaces (e.g., playgrounds with rubber) to prevent allergic reactions.
- C. Encourage a varied diet to prevent allergies.
- D. Provide brightly colored objects to stimulate development.
Correct Answer: B
Rationale: Children with urologic malformations are prone to latex allergies; parents should be advised to avoid latex exposure.
The nurse is conducting a staff in-service on childhood-acquired heart diseases. Which is a major clinical manifestation of rheumatic fever?
- A. Polyarthritis
- B. Osler nodes
- C. Janeway spots
- D. Splinter hemorrhages of distal third of nails
Correct Answer: A
Rationale: Rheumatic fever is a systemic inflammatory condition that can develop as a complication of untreated or inadequately treated streptococcal infections, such as strep throat. One of the major clinical manifestations of rheumatic fever is polyarthritis, which is characterized by inflammation and pain in multiple joints. It typically involves large joints like the knees, ankles, elbows, and wrists. Polyarthritis in rheumatic fever is migratory in nature, meaning the joint pain shifts from one joint to another over a period of time. Other common clinical manifestations of rheumatic fever include carditis (inflammation of the heart), chorea (involuntary movements), subcutaneous nodules, and erythema marginatum (rash).
Although the etiology of hepatoblastoma is unknown, there are many associated risk factors for development of hepatoblastoma EXCEPT
- A. Beckwith-Wiedemann syndrome
- B. familial adenomatous polyposis syndrome
- C. prematurity
- D. Hepatitis C
Correct Answer: D
Rationale: Hepatitis C infection is not a recognized risk factor for hepatoblastoma.
the most dangerous complication of untreated hypothyroidism is
- A. mental retardation.
- B. hypertension.
- C. low weight gain.
- D. sensitivity to heat.
Correct Answer: A
Rationale: The most dangerous complication of untreated hypothyroidism is mental retardation, especially in infants and children. Thyroid hormones play a vital role in the brain development of infants and young children. Severe and prolonged hypothyroidism during this critical period can lead to irreversible cognitive impairment, affecting intelligence and neurodevelopment. Therefore, timely diagnosis and treatment of hypothyroidism are essential to prevent this serious complication, particularly in children.