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An 8-day-old is admitted with vomiting and dehydration. His HR is 170, RR is 44, BP is 85/52, and T is 99°F. The parents ask if these vital signs are normal. Which is the best response?
- A. The BP is elevated.
- B. The temperature is elevated.
- C. The heart rate is elevated; normal for a neonate is 90-160 bpm.
- D. The respiratory rate is elevated.
Correct Answer: C
Rationale: A neonatal heart rate of 170 is above the normal range (90-160 bpm), which is concerning for dehydration.
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Which statement, from a participant attending the class on AIDS prevention, indicates an understanding on how to reduce transmission of HIV?
- A. Mother's who are HIV positive should still be encouraged to breastfeed their babies because beast milk is superior to cow's milk
- B. I think a needle exchange program, where clean needles are exchanged for dirty needles, should be offered in every city
- C. Females taking birth control pills are protected from getting HIV
- D. It's okay to use natural skin condoms since they offer the same protection as the latex condoms
Correct Answer: B
Rationale: The correct answer is B because implementing a needle exchange program is an effective way to reduce transmission of HIV among intravenous drug users. By providing clean needles in exchange for dirty needles, the risk of sharing contaminated needles and spreading the virus is significantly reduced. This approach also helps prevent the transmission of other bloodborne diseases, such as Hepatitis C. The other statements do not demonstrate an understanding of how to reduce HIV transmission - for example, encouraging breastfeeding for HIV-positive mothers can transmit the virus to the baby, birth control pills do not protect against HIV, and natural skin condoms do not offer the same level of protection as latex condoms.
Which of the following organisms is responsible for the development of rheumatic fever?
- A. Streptococcal pneumonia
- B. Haemophilus influenza
- C. Group Aß-hemolytic streptococcus
- D. Staphylococcus aureus
Correct Answer: C
Rationale: Rheumatic fever is an inflammatory disease that can develop after an untreated or inadequately treated infection with group Aß-hemolytic streptococcus bacteria, particularly Streptococcus pyogenes. This bacteria causes strep throat, which if left untreated, can lead to complications such as rheumatic fever. Rheumatic fever primarily affects the heart, joints, skin, and brain. It is important to promptly treat streptococcal infections with antibiotics to prevent the development of rheumatic fever.
A client has a serum calcium level of 7.2mg/dl. During the physical examination, the nurse expects to assess:
- A. Trousseau's sign
- B. Hegar's sign
- C. Homan's sign
- D. Goodell's sign
Correct Answer: A
Rationale: A client with a low serum calcium level (hypocalcemia) is at risk for exhibiting Trousseau's sign. Trousseau's sign is a clinical manifestation of hypocalcemia characterized by carpal spasm induced by inflating a blood pressure cuff on the arm above the systolic pressure for a few minutes. This spasm occurs due to the increased neuromuscular irritability caused by low calcium levels. Therefore, a nurse assessing a client with a serum calcium level of 7.2mg/dl should expect to assess Trousseau's sign.
Nurse Veronica is teaching a group of parents about otitis media. When discussing why children are predisposed to this disorder, the nurse should mention the significance of which anatomical feature?
- A. Nasopharynx
- B. Eustachian tubes
- C. External ear canal
- D. Tympanic membrane 51
Correct Answer: B
Rationale: The Eustachian tubes are small passages that connect the middle ear to the back of the throat. In young children, these tubes are shorter, more horizontal, and more narrow than in adults, making them more prone to blockages and infections. When these tubes become blocked, usually due to factors like swelling from allergies or a cold, fluid can build up in the middle ear leading to otitis media or middle ear infection. Therefore, the anatomy and size of the Eustachian tubes play a significant role in the predisposition of children to otitis media.
Radiotherapy is an effective modality of treatment in variable pediatric solid tumors. Of the following, the LEAST responsive tumor to radiotherapy is
- A. rhabdomyosarcoma
- B. neuroblastoma
- C. nephroblastoma
- D. osteosarcoma
Correct Answer: D
Rationale: Osteosarcoma is relatively radioresistant compared to other listed tumors.