Nokea
An adolescent client reports to the nurse of walking with a limp due to pain localized in the right knee which worsens at night but denies any recent injury or trauma. The nurse observes swelling and tenderness in the right lower thigh and imaging results reveal radial ossification in the soft tissues. What condition should the nurse consider as the probable cause of the findings?
- A. Osteosarcoma
- B. Hemosiderosis
- C. Growing pains
- D. Rhabdomyolysis
Correct Answer: A
Rationale: Symptoms and radial ossification suggest osteosarcoma, a common bone tumor in adolescents.
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When initiating a peripheral intravenous (IV) infusion on an infant, what action should the nurse take?
- A. Apply soft restraints to all four extremities.
- B. Assess the dorsal surface of the feet for an IV site.
- C. Instruct parents to sing or croon to the infant.
- D. Select a site that is least restrictive to the infant.
Correct Answer: D
Rationale: Choosing a least restrictive site minimizes distress and allows easier movement post-IV insertion.
The nurse is evaluating a child with acute glomerulonephritis who presents at the clinic with increased fatigue, facial swelling, and decreased appetite. The child's urine sample is dark yellow. What additional finding should the nurse report to the healthcare provider?
- A. Blood pressure 88/50 mmHg
- B. Weight loss
- C. Maculopapular rash over the trunk of the body
- D. Positive rapid strep test of the oropharynx
Correct Answer: D
Rationale: A positive strep test indicates a recent infection, a common cause of glomerulonephritis, requiring reporting.
The nurse is caring for a child with hypoparathyroidism who exhibits a carpal spasm when pressure is applied to the upper arm. Which laboratory value should the nurse review?
- A. Sodium
- B. Calcium
- C. Potassium
- D. Chloride
Correct Answer: B
Rationale: Carpal spasm (Trousseau's sign) indicates hypocalcemia, common in hypoparathyroidism.
The nurse is caring for an adolescent with type 1 diabetes mellitus who presents with an HbA1c of 11% (97 mmol/mol), thirst, and blurred vision. What action should the nurse take first?
- A. Obtain point-of-care glucose.
- B. Assess urine for ketones.
- C. Check blood pressure.
- D. Review prior insulin prescriptions.
Correct Answer: A
Rationale: Symptoms suggest hyperglycemia; point-of-care glucose testing confirms this and guides treatment.
A 9-week-old infant is scheduled for a cleft lip repair. What information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?
- A. Urine specific gravity is 1.011
- B. White blood cell count of 10,000/mm³
- C. Weight gain of 2 pounds (0.91 kg) since birth
- D. Red blood cell count of 2.3 x 10²/L
Correct Answer: D
Rationale: A low red blood cell count indicates anemia, a surgical risk requiring preoperative attention.