Nokea
An infant who has been in foster care since birth requires a blood transfusion. Who is authorized to give written, informed consent for the procedure?
- A. The foster mother
- B. The social worker who placed the infant in the foster home
- C. The registered nurse caring for the infant
- D. The nurse-manager
Correct Answer: A
Rationale: The foster mother, as the primary caregiver, is typically authorized to provide consent for medical procedures.
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Epiphyseal changes are seen in:
- A. Non-accidental injury
- B. Rickets
- C. Chronic renal failure
- D. Lead poisoning
Correct Answer: B
Rationale: Rickets is characterized by epiphyseal changes due to defective mineralization of growing bones.
A grade II vibratory, mid-systolic murmur at the mid sternal border in a 4-year-old child that is louder when the child is supine is most likely which type of murmur?
- A. Pathologic murmur
- B. Pulmonary flow murmur
- C. Still's murmur
- D. Venous hum
Correct Answer: C
Rationale: A Still's murmur is characterized by a vibratory or musical low-grade sound, along the sternal border, which is louder when the child is supine or during inspiration.
A child has been diagnosed with valvular disease following rheumatic fever (RF). During patient teaching, the nurse discusses the child's long-term prophylactic therapy with antibiotics for dental procedures, surgery, and childbirth. The parents indicate they understand when they say:
- A. She will need to take the antibiotics until she is 18 years old.
- B. She will need to take the antibiotics for 5 years after the last attack.
- C. She will need to take the antibiotics for 10 years after the last attack.
- D. She will need to take the antibiotics for the rest of her life.
Correct Answer: D
Rationale: Valvular involvement indicates significant damage; therefore, lifelong prophylactic antibiotics are required.
A nurse is caring for a child with Down syndrome. Which statement by the parent indicates the need for further teaching?
- A. I will make sure my child has regular hearing screenings.
- B. I will encourage my child to be active and participate in play.
- C. I should monitor my child's thyroid function regularly.
- D. I should avoid giving my child a multivitamin supplement.
Correct Answer: D
Rationale: Children with Down syndrome may benefit from a multivitamin supplement, especially if they are at risk for nutritional deficiencies.
Acute laryngotracheobronchitis in children:
- A. Needs to be treated by broad-spectrum antibiotics
- B. Humidified oxygen by tent needs to be administered in infancy
- C. Dexamethasone is known to shorten the duration of illness
- D. Adrenaline by nebuliser is absolutely contraindicated
Correct Answer: C
Rationale: Dexamethasone, a corticosteroid, is known to reduce inflammation and shorten the duration of illness in acute laryngotracheobronchitis (croup).