Nokea
A nurse in the emergency department is observing a 4-year-old child for signs of increased intracranial pressure after a fall from a bicycle, resulting in head trauma. Which of the following signs or symptoms would be cause for concern?
- A. Bulging anterior fontanel
- B. Repeated vomiting
- C. Signs of sleepiness at 10 PM
- D. Inability to read short words from a distance of 18 inches
Correct Answer: B
Rationale: Increased intracranial pressure after head trauma can lead to serious complications. Repeated vomiting is a concerning sign as it can indicate stimulation of the vomiting center within the brainstem due to increased pressure. This can be an early indicator of raised intracranial pressure and the need for urgent medical intervention. Bulging anterior fontanel may not be immediately apparent in a 4-year-old child and is more common in infants. Signs of sleepiness at a particular time of day are not specific to increased intracranial pressure. Inability to read short words from a distance of 18 inches may indicate vision problems but is not directly related to intracranial pressure.
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A healthcare professional is reviewing a patient's chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition?
- A. Yersinia pestis
- B. Helicobacter pylori
- C. Vibrio cholerae
- D. Haemophilus aegyptius
Correct Answer: D
Rationale: The correct answer is Haemophilus aegyptius. Haemophilus influenzae biogroup aegyptius (Hae) is a causative agent of acute and often purulent conjunctivitis, more commonly known as pink eye. Yersinia pestis, Helicobacter pylori, and Vibrio cholerae are not associated with conjunctivitis. Yersinia pestis causes the plague, Helicobacter pylori is associated with gastric ulcers, and Vibrio cholerae causes cholera.
A patient's chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute?
- A. Vomiting
- B. Extreme Thirst
- C. Weight gain
- D. Acetone breath smell
Correct Answer: C
Rationale: In acute ketoacidosis, a patient typically experiences rapid weight loss due to the body burning fat and muscle for energy in the absence of sufficient insulin. Therefore, weight gain would not be expected. Vomiting may occur due to the metabolic disturbances associated with ketoacidosis. Extreme thirst is a common symptom as the body tries to compensate for dehydration. Acetone breath smell is a classic sign of ketoacidosis as acetone is one of the ketones produced during this condition.
In which of the following conditions would a healthcare provider not administer erythromycin?
- A. Campylobacteriosis infection
- B. Legionnaires disease
- C. Pneumonia
- D. Multiple Sclerosis
Correct Answer: D
Rationale: Erythromycin is an antibiotic used to treat bacterial infections. Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system, involving the brain and spinal cord. Since MS is not caused by bacteria, administering erythromycin would not be appropriate. Campylobacteriosis infection, Legionnaires disease, and pneumonia are bacterial infections that can be treated with erythromycin, making them incorrect choices for conditions where erythromycin would not be administered.
In a pediatric clinic, a nurse is assessing a child recently diagnosed with cystic fibrosis. Which of the following later findings of this disease would the nurse not expect to see at this time?
- A. Positive sweat test
- B. Bulky greasy stools
- C. Moist, productive cough
- D. Meconium ileus
Correct Answer: C
Rationale: In a child newly diagnosed with cystic fibrosis (CF), noisy respirations and a dry, non-productive cough are typically the first respiratory signs to appear. The other options, including a positive sweat test, bulky greasy stools, and meconium ileus, are among the earliest findings of CF. CF is a genetic condition that affects the production of mucus, sweat, saliva, and digestive juices. Due to a defective gene, these secretions become thick and sticky instead of thin and slippery, leading to blockages in various passageways, especially in the pancreas and lungs. Respiratory failure is a severe consequence of CF, making it crucial to monitor respiratory symptoms closely in affected individuals. Therefore, a moist, productive cough would not be an expected finding in a newly diagnosed child with CF.
A 28-year-old male has been found wandering around in a confusing pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first?
- A. Blood sugar check
- B. CT scan
- C. Blood cultures
- D. Arterial blood gases
Correct Answer: A
Rationale: In a 28-year-old male presenting with confusion, sweating, and pallor, the most likely cause is hypoglycemia, especially with no mention of trauma or infection. Therefore, the initial test to be performed should be a blood sugar check to rule out low blood sugar levels. Checking blood sugar levels is crucial in such a scenario as hypoglycemia can lead to altered mental status. A CT scan (choice B) is not typically the initial test for altered mental status without any focal neurological signs or head trauma. Blood cultures (choice C) are more relevant in cases suspected of infection, which is not a primary concern in this scenario. Arterial blood gases (choice D) may be considered later if there are concerns about respiratory status or acid-base disturbances, but in this case, checking the blood sugar level is the most immediate and appropriate action.