Nokea
An adolescent with new-onset diabetes is struggling with 'daytime accidents.' What is this condition called?
- A. Primary enuresis.
- B. Secondary enuresis.
- C. Diurnal enuresis.
- D. Nocturnal enuresis.
Correct Answer: C
Rationale: Secondary enuresis is the recurrence of incontinence in a child who had previously achieved bladder control.
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Recommendations for hepatitis B (HBV) vaccine include which statement?
- A. First dose is given between birth and age 2 days.
- B. First dose is given between ages 12 and 15 months.
- C. It is not recommended for neonates who are at low risk for hepatitis B.
- D. It is not recommended for neonates whose mothers are positive for HBV surface antigen.
Correct Answer: B
Rationale: The current recommendations for hepatitis B (HBV) vaccine state that the first dose should be administered between ages 12 and 15 months. The vaccine series typically consists of three doses, with the second dose administered 1-2 months after the first dose, and the third dose given at least 8 weeks after the second dose. This schedule is recommended by the Centers for Disease Control and Prevention (CDC) to provide optimal protection against the hepatitis B virus. Starting the vaccine series at 12-15 months ensures that the child's immune system is mature enough to respond effectively to the vaccine and generate lasting immunity.
In growing children, growth hormone deficiency results in short stature and very slow growth rates. Short stature may result from which of the following?
- A. Anterior pituitary gland hypofunction
- B. Posterior pituitary gland hyperfunction
- C. Parathyroid gland hyperfunction
- D. Thyroid gland hyperfunction
Correct Answer: A
Rationale: Short stature due to growth hormone deficiency commonly occurs as a result of anterior pituitary gland hypofunction. The anterior pituitary gland is responsible for releasing growth hormone, which is crucial for proper growth and development, especially during childhood. When there is a deficiency of growth hormone, children may experience slowed growth rates and ultimately result in short stature. Other gland dysfunctions mentioned in the choices, such as posterior pituitary gland hyperfunction, parathyroid gland hyperfunction, and thyroid gland hyperfunction, do not directly impact growth hormone production and are not associated with growth hormone deficiency-related short stature in children.
A 3-year-old child from a suburban community presents with vomiting, diarrhea, and blurred vision. Physical examination reveals an afebrile child with pinpoint pupils, salivation, and muscular fasciculations. The child's lawn was treated yesterday for insects. Which of the following tests will establish the correct diagnosis?
- A. Blood-lead level
- B. 24-hour urine mercury level
- C. Plasma cholinesterase level
- D. Urine malathion level
Correct Answer: C
Rationale: The symptoms suggest organophosphate poisoning, which can be confirmed by measuring plasma cholinesterase levels, as organophosphates inhibit this enzyme.
You are discussing failure to thrive (FTT) with medical students. You mention that FTT is most often used to describe malnutrition related to environmental or psychosocial causes. An important statement that should be included in your discussion is
- A. FTT is often diagnosed by weight that falls below the 25th percentile for age
- B. a weight crossing one major percentile lines on the growth height should be evaluated for FTT chart over time is considered abnormal
- C. a weight of less than 60 % of the median weight for the height of the child
- D. small subset of the population naturally falls below the 3rd percentile but usually have normal weight for height
Correct Answer: B
Rationale: Crossing percentile lines on a growth chart indicates a significant deviation from the child's previous growth trajectory, which is a key indicator of potential FTT.
The nurse is interviewing a client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?
- A. Duodenal ulcer
- B. Weight gain
- C. Hemorrhoids
- D. Polyps
Correct Answer: D
Rationale: The presence of polyps in the colon is a significant risk factor for developing colorectal cancer. Polyps are abnormal growths in the inner lining of the colon or rectum that can potentially become cancerous over time if left untreated. Therefore, if a client has a history of polyps, the nurse may suspect the possibility of colorectal cancer and should closely monitor the client for any signs or symptoms. While the other conditions listed may sometimes be associated with colorectal cancer, having a history of polyps is the most concerning in this context.