Nokea
A worried mother of a 4-year-old boy describes attacks of inconsolable crying and prefers to play alone. The MOST appropriate action is
- A. reassures her that this is a normal phenomenon
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate social issues of the family
Correct Answer: B
Rationale: Further history is needed to rule out behavioral or psychological issues.
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A client with acquired immunodeficiency syndrome (AIDS) is receiving zidovudine (azidothymidine, AZT [Retrovir]). To check for adverse drug effects, the nurse should monitor the results of laboratory test?
- A. RBC count
- B. Serum calcium
- C. Fasting blood glucose
- D. Platelet count
Correct Answer: D
Rationale: Zidovudine (azidothymidine, AZT [Retrovir]) is an antiretroviral medication used to treat human immunodeficiency virus (HIV) infection. One of the potential adverse effects of zidovudine is bone marrow suppression, which can lead to decreased production of blood cells including platelets. Monitoring the platelet count is essential because a low platelet count (thrombocytopenia) can result in an increased risk of bleeding and bruising. Therefore, regular monitoring of platelet count is crucial to detect and manage this potential adverse effect promptly in patients receiving zidovudine therapy. Monitoring other laboratory tests such as RBC count, serum calcium, and fasting blood glucose may also be important for assessing overall health status, but platelet count monitoring takes priority due to the risk of thrombocytopenia associated with zidovudine therapy.
For children receiving steroid therapy, which of the following regimens is most appropriate for perioperative management?
- A. Prednisone 1 mg/kg given 24 and 12 hours before surgery
- B. Dexamethasone 0.6 mg/kg IV given 24 and 12 hours before surgery
- C. Hydrocortisone 5 mg/kg IV given 24 and 12 hours before surgery
- D. Methylprednisolone 10 mg/kg IV given 24 and 12 hours before surgery
Correct Answer: C
Rationale: Hydrocortisone is commonly used for perioperative steroid coverage due to its mineralocorticoid and glucocorticoid effects.
Osteosarcoma is the most common primary malignant bone tumor in children and adolescents; it has multiple subtypes and requires different modalities of treatment including surgery and chemotherapy. Of the following, the subtype of osteosarcoma which is treated by surgery alone is
- A. fibroblastic
- B. chondroblastic
- C. parosteal
- D. periosteal
Correct Answer: D
Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.
While obtaining a health history, the nurse learns that the client is allergic to bee stings. When obtaining the client's medication history, the nurse should determine if the client keeps which medication on hand?
- A. Diphenhydramine hydrochloride (Benadryl)
- B. Guaifenesin (Robitussin)
- C. Pseudoephedrine hydrochloride (Sudafed)
- D. Loperamide (Imodium)
Correct Answer: A
Rationale: The nurse should determine if the client keeps diphenhydramine hydrochloride (Benadryl) on hand because it is an antihistamine medication commonly used to treat allergic reactions, including those caused by bee stings. In the event of a bee sting reaction, diphenhydramine can help reduce itching, swelling, and other symptoms associated with the allergy. It is important for individuals who are allergic to bee stings to have diphenhydramine readily available for prompt treatment in case of an allergic reaction.
Older school-age children who begin to participate in competitive sports should have a careful evaluation of the
- A. vision
- B. hearing
- C. sexual maturity
- D. cardiovascular system
Correct Answer: D
Rationale: Cardiovascular evaluation is important for children participating in competitive sports.