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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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Extraneural metastasis from primary brain tumors is MOST commonly likely to occur in which tumor?
- A. medulloblastoma
- B. primitive neuroectodermal tumor (PNET)
- C. ependymoma
- D. malignant glioma
Correct Answer: A
Rationale: Medulloblastoma is notorious for extraneural spread, particularly to bones and bone marrow.
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.
The nurse is caring for a 5-year-old child with impetigo contagiosa. The parents ask the nurse what will happen to their child's skin after the infection has subsided and healed. Which answer should the nurse give?
- A. There will be no scarring.
- B. There may be some pigmented spots.
- C. It is likely there will be some slightly depressed scars.
- D. There will be some atrophic white scars.
Correct Answer: A
Rationale: Impetigo contagiosa typically does not leave scarring once it has subsided and healed. This skin infection primarily affects the superficial layers of the skin and does not cause damage deep enough to result in scarring. While there may be some temporary pigmented spots or mild changes in skin color after the infection resolves, scarring is not a common outcome of impetigo contagiosa in most cases. Thus, the nurse should reassure the parents that their child's skin is not likely to have any scarring after the infection has healed.
The clue to need a help for a child who does not respond correctly to 'Give me' or 'Sit down' or 'Come here' when spoken without gestural cues is by age of
- A. 15 months
- B. 18 months
- C. 21 months
- D. 24 months
Correct Answer: D
Rationale: By 24 months, a child should be able to follow simple commands without gestures.
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.