All the following are compatible with the definition of obstructive sleep apnea EXCEPT
- A. episodes of prolonged upper airway obstruction
- B. repeated apnea
- C. 230% reduction in airflow
- D. 2-30% O2 desaturation
Correct Answer: D
Rationale: Oxygen desaturation of 2-30% is too low to define mild-to-moderate sleep apnea.
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A 2-year-old child is being evaluated for a right flank mass; radiological appearance is consistent with rupture of Wilms tumor. The BEST therapeutic approach for this child is
- A. radiotherapy
- B. concomitant chemotherapy-radiotherapy
- C. another surgery
- D. observation
Correct Answer: B
Rationale: Concomitant chemotherapy and radiotherapy are essential to manage ruptured Wilms tumor and reduce the risk of dissemination.
How does nosocomial pneumonia occur?
- A. In a healthcare setting
- B. Within 48hrs of admission to a healthcare
- C. In the immunocompromised host facility
- D. In a community setting
Correct Answer: A
Rationale: Nosocomial pneumonia occurs in a healthcare setting. It is a type of pneumonia that is contracted during a hospital stay or other healthcare facilities. The risk of developing nosocomial pneumonia is higher in patients who are already hospitalized due to various medical conditions, surgeries, or use of medical devices like ventilators. The infection can be caused by different types of bacteria, viruses, or fungi present in the healthcare environment. Preventive measures, such as proper hand hygiene, infection control practices, and minimizing the use of invasive devices, are crucial in reducing the incidence of nosocomial pneumonia.
A brain abscess is a collection of pus within the substance of the brain and is caused by:
- A. Direct invasion of the brain
- B. Spread of infection by other organs
- C. Spread infection from nearby sites
- D. All of the above mechanisms
Correct Answer: D
Rationale: A brain abscess can be caused by direct invasion of the brain by microorganisms, spread of infection by other organs (such as the heart or lungs), or spread of infection from nearby sites (such as sinuses or the middle ear). In some cases, multiple mechanisms can contribute to the development of a brain abscess. Therefore, the correct answer is that a brain abscess can be caused by all of the above mechanisms.
Children with severe traumatic brain injury (TBI) may experience autonomic dysfunction characterized by all the following EXCEPT
- A. elevated temperature
- B. elevated heart rate
- C. elevated respiratory rate
- D. lowered blood pressure
Correct Answer: D
Rationale: Autonomic dysfunction in TBI typically involves elevated temperature, heart rate, and respiratory rate due to dysregulation of the autonomic nervous system. Lowered blood pressure is less common and may indicate hypovolemia or other conditions rather than autonomic dysfunction.
While caring for a patient who is hospitalized for acute gastroenteritis and dehydration, the pediatric nurse notes that the patient's parent keeps packets of herbs by the patient's bedside. Suspecting that the parent may be administering the herbs to the patient, the nurse's first action is to:
- A. ask the parent in a nonjudgmental manner about the herbs.
- B. coordinate a nursing care conference to discuss the patient's plan of care.
- C. discuss the risks of using alternative therapies with the parent.
- D. refer the family to a social worker for possible nonadherence with the healthcare regimen.
Correct Answer: A
Rationale: A nonjudgmental approach encourages open communication and allows the nurse to assess the situation appropriately.