Nokea
A nurse is providing parental instruction for a 24-hour urine collection for a hospitalized child. Which of the following statements by the child's parent needs further instruction?
- A. This test is to evaluate kidney function.'
- B. This test is timed with the first urine collection.'
- C. This container can be kept in the unit refrigerator.'
- D. The container comes from the laboratory.'
Correct Answer: C
Rationale: Urine collection containers should be kept cool but not in a shared refrigerator due to contamination risks; a specific cooler is used, indicating a need for clarification.
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A 4-year-old boy presents with fever, limp, and hip pain. Hip x-ray is normal, but ESR is elevated. Most likely diagnosis is:
- A. Septic arthritis
- B. Transient synovitis
- C. Osteomyelitis
- D. Slipped capital femoral epiphysis
Correct Answer: B
Rationale: Transient synovitis is common in preschoolers with limp and fever, often post-viral, with normal x-ray, per AAP. A, C-E have different presentations or imaging.
A 3-month-old infant presents with tachypnea and poor feeding. Chest x-ray shows cardiomegaly and pulmonary edema. Most likely diagnosis is:
- A. Pneumonia
- B. Congestive heart failure
- C. Bronchiolitis
- D. Cystic fibrosis
Correct Answer: B
Rationale: CHF shows cardiomegaly and edema, per AHA. A, C-E differ.
A child with a cast should be taught to report
- A. Discomfort
- B. Numbness
- C. Tingling
- D. All of the above
Correct Answer: D
Rationale: All D may indicate circulation issues, per document p28, .
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.
Most common complication of untreated congenital adrenal hyperplasia is:
- A. Adrenal crisis
- B. Sexual infantilism
- C. Hirsutism
- D. Precocious puberty
Correct Answer: A
Rationale: Adrenal crisis is the most serious complication of untreated CAH due to cortisol deficiency, per AAP (doc p148, Q558).