Nokea
About 500 children have just been exposed to radiation from a nuclear power plant accident. The most appropriate first step in your treatment of these children should be to
- A. prescribe potassium iodide to protect the thyroid
- B. order thyroid function tests
- C. order complete blood counts (CBCs)
- D. do nothing acutely; evaluate in 4-6 weeks
Correct Answer: A
Rationale: Potassium iodide can protect the thyroid from radioactive iodine exposure, which is a critical first step in radiation exposure.
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A 5-year old boy presents with afebrile generalized tonic-clonic seizure lasting for 5 minutes. Previously he was healthy and had no such problem. On examination there is no abnormality. Your plan of management should be:
- A. Start anticonvulsant therapy
- B. Request for an EEG and wait for its report
- C. Request for an EEG and start anticonvulsant therapy immediately
- D. Request for EEG and MRI brain
Correct Answer: C
Rationale: In a first-time generalized seizure, an immediate EEG and starting anticonvulsant therapy is prudent to prevent recurrence, especially if the EEG shows epileptiform activity.
An adolescent girl tells the nurse that she is very suicidal. The nurse asks her whether she has a specific plan. Asking this should be considered:
- A. an appropriate part of the assessment.
- B. not a critical part of the assessment.
- C. suggesting that the adolescent needs a plan.
- D. encouraging the adolescent to devise a plan.
Correct Answer: A
Rationale: Asking an adolescent girl who expresses suicidal thoughts whether she has a specific plan is an appropriate part of the assessment. This question helps the nurse determine the level of risk and urgency of the situation. Knowing whether there is a specific plan in place can guide the nurse in determining the appropriate intervention and level of care needed to ensure the safety and well-being of the adolescent. It is crucial to assess for the presence of a specific plan as it can indicate a higher risk of imminent harm.
The neurologist tests the 4th and 6th cranial nerves together by having a patient do which of the following?
- A. Turn his head to the right and left
- B. Say "ahhh"
- C. Identify whispering in his ears
- D. Follow his finger with his eyes
Correct Answer: D
Rationale: The neurologist tests the 4th and 6th cranial nerves together by having a patient follow his finger with his eyes. The 4th cranial nerve (trochlear nerve) innervates the superior oblique muscle, which primarily moves the eye downward and outward. The 6th cranial nerve (abducens nerve) innervates the lateral rectus muscle, which primarily moves the eye laterally. Testing these cranial nerves simultaneously by asking the patient to follow the neurologist's finger helps assess the coordination and function of both of these nerves, which are important for eye movement control.
What causes tinea capitis (ringworm)?
- A. Virus
- B. Fungus
- C. Allergic reaction
- D. Bacterial infection
Correct Answer: B
Rationale: Tinea capitis, also known as ringworm of the scalp, is a fungal infection caused by various dermatophyte fungi, primarily Trichophyton and Microsporum species. These fungi thrive on dead tissues, including hair, skin, and nails, and can lead to symptoms like red, scaly patches on the scalp, hair loss, and itching. The infection is contagious and can spread through direct contact with an infected person, animals, or contaminated objects. Proper diagnosis and treatment with antifungal medications are essential to manage tinea capitis effectively.
Cherry, the mother of an 11-month-old girl, Elizabeth, is in the clinic for her daughter's immunizations. She expresses concern to the nurse that Elizabeth cannot yet walk. The nurse correctly replies that, according to the Denver Developmental Screen, the median age for walking is:
- A. 12 months.
- B. 15 months.
- C. 10 months.
- D. 14 months.
Correct Answer: A
Rationale: The Denver Developmental Screening Test states that the median age for walking is around 12 months. This means that about half of all typically developing children will begin to walk by this age. It is important to note that there is a wide range of normal development, and not all children will hit these milestones at the same time. If Cherry's 11-month-old daughter, Elizabeth, is not yet walking, it does not necessarily indicate a developmental delay as long as she is meeting other milestones within a reasonable timeframe.