Nokea
Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories include:
- A. avoidance of eye contact.
- B. an associated malabsorption defect.
- C. weight that falls below the 15th percentile.
- D. normal achievement of developmental landmarks.
Correct Answer: C
Rationale: Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories may include weight that falls below the 15th percentile on growth charts. Weight falling below the 15th percentile may indicate poor nutrition intake leading to inadequate growth and development. Other signs such as avoidance of eye contact, an associated malabsorption defect, and normal achievement of developmental landmarks may not be specific indicators of failure to thrive due to behavioral problems with inadequate calorie intake.
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The nurse is conducting a staff in-service on childhood-acquired heart diseases. Which is a major clinical manifestation of rheumatic fever?
- A. Polyarthritis
- B. Osler nodes
- C. Janeway spots
- D. Splinter hemorrhages of distal third of nails
Correct Answer: A
Rationale: Rheumatic fever is a systemic inflammatory condition that can develop as a complication of untreated or inadequately treated streptococcal infections, such as strep throat. One of the major clinical manifestations of rheumatic fever is polyarthritis, which is characterized by inflammation and pain in multiple joints. It typically involves large joints like the knees, ankles, elbows, and wrists. Polyarthritis in rheumatic fever is migratory in nature, meaning the joint pain shifts from one joint to another over a period of time. Other common clinical manifestations of rheumatic fever include carditis (inflammation of the heart), chorea (involuntary movements), subcutaneous nodules, and erythema marginatum (rash).
A 13-year-old is worried because his breasts are growing and are tender. What should the nurse tell him?
- A. We will draw blood to determine the cause.
- B. It is a slight hormonal imbalance that can be corrected with medication.
- C. It is a normal condition of puberty (gynecomastia) that usually resolves within a year or two.
- D. It is a rare finding in boys during puberty.
Correct Answer: C
Rationale: Gynecomastia and breast tenderness occur in about one-third of boys during mid-puberty and usually resolve within 2 years.
The nurse is assigned to a client with polymyositis. Which expected outcome in the plan of care relates to a potential problem associated with polymyositis?
- A. "Client will lose 2lb per week on a calorie-restricted diet."
- B. "Client will exhibit no signs or symptoms of aspiration."
- C. "Client will exhibit bowel and bladder continence."
- D. "Client will exhibit alertness and orientation to person, place, and time."
Correct Answer: B
Rationale: Polymyositis is a condition that involves inflammation of the muscles, including the muscles involved in swallowing (dysphagia) and breathing. This can lead to a higher risk of aspiration, where food or fluids go into the airway instead of the esophagus. Therefore, monitoring for signs and symptoms of aspiration and ensuring the client exhibits no signs of aspiration are crucial in the care of a client with polymyositis. The other options are not directly related to the potential problems associated with polymyositis and are more general aspects of nursing care.
Nurse Kai is evaluating a female child with acute post-streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?
- A. Increased urine output
- B. Increased appetite
- C. Increased energy level
- D. Decreased diarrhea
Correct Answer: A
Rationale: In a female child with acute post-streptococcal glomerulonephritis, the earliest sign of improvement is often seen as an increase in urine output. This occurs as the kidneys start to recover and normal functioning is restored. Increased urine output indicates improved glomerular filtration and clearance of waste products from the body. It is an essential indicator of renal function and overall improvement in the condition of the child. Other signs such as increased appetite and energy levels may follow but increased urine output is typically the first noticeable sign of improvement in cases of glomerulonephritis.
Which of the following disorders leads to cyanosis from deoxygenated blood entering the systemic arterial circulation?
- A. Aortic stenosis (AS)
- B. Coarctation of aorta
- C. Patent ductus arteriosus (PDA)
- D. Tetralogy of Fallot
Correct Answer: D
Rationale: Tetralogy of Fallot is a congenital heart defect characterized by four primary abnormalities: pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. Due to the pulmonary stenosis, less blood reaches the lungs to be oxygenated, resulting in deoxygenated blood entering the systemic arterial circulation. This leads to cyanosis, which is often referred to as "Tet spells" in these patients. Cyanosis is the bluish discoloration of the skin and mucous membranes caused by the presence of deoxygenated hemoglobin. The other conditions listed do not typically result in deoxygenated blood entering the systemic arterial circulation and causing cyanosis.