Nokea
About juvenile chronic arthritis:
- A. Rheumatoid factor is an important diagnostic test to perform in suspected cases
- B. Pauciarticular type is the commonest type
- C. Cervical spine involvement is uncommon
- D. Methotrexate is the first line drug in therapy
Correct Answer: B
Rationale: Pauciarticular juvenile idiopathic arthritis (JIA) is the most common subtype, typically affecting fewer than five joints in the first six months of disease.
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A male client with muscular dystrophy fell in his home and is admitted with a right hip fracture. His right foot is cool, with palpable pedal pulses. Lungs are coarse with diminished bibasilar breath sounds. Vital signs are temperature 101F, heart rate 128 beats/minute, respirations 28 breaths/minute, and blood pressure 122/82. Which intervention is most important for the nurse to implement first?
- A. Obtain oxygen saturation level
- B. Encourage incentive spirometry
- C. Assess lower extremity circulation
- D. Administer PRN oral antipyretic
Correct Answer: D
Rationale: Administering an antipyretic addresses the fever, which is a priority in this client to prevent further complications.
The primary care pediatric nurse practitioner is performing a sports physical on an adolescent whose history reveals mild aortic stenosis (AS). What will the nurse practitioner recommend?
- A. Avoidance of all sports to prevent sudden death
- B. Clearance for any sports since this is mild
- C. Evaluation by a cardiologist prior to participation
- D. Low-intensity sports
Correct Answer: C
Rationale: Children with mild AS may participate in any sport but must have annual cardiac evaluations.
When caring for a client with nephrotic syndrome, which assessment is most important for the nurse to obtain?
- A. Daily weight
- B. Vital signs
- C. Level of consciousness
- D. Bowel sounds
Correct Answer: A
Rationale: Daily weight is crucial in monitoring fluid balance in clients with nephrotic syndrome, as they are prone to edema.
Whirlpool' sign in abdominal ultrasonogram is seen in
- A. Duodenal atresia
- B. Midgut volvulus
- C. Intussusception
- D. Anorectal malformation
Correct Answer: B
Rationale: The 'whirlpool' sign on abdominal ultrasound is characteristic of midgut volvulus, indicating twisting of the intestines around the mesenteric vessels.
An 8-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than _____ beats/min.
- A. 60
- B. 70
- C. 90
- D. 100
Correct Answer: B
Rationale: If a 1-minute apical pulse is less than 70 beats/min for an older child, the digoxin is withheld; 60 beats/min is the cut-off for holding the digoxin dose in an adult. A pulse below 90 to 110 beats/min is the determination for not giving a digoxin dose to infants and young children.