Nokea
Deteriorating insulation is found in the ceilings of a local school built in 195Parents and teachers are extremely concerned that it may be asbestos, and they call on you, the local pediatrician, to give advice in an open meeting. What advice would you give?
- A. Immediately remove all of the insulation.
- B. Confirm the presence of asbestos by laboratory evaluation, and do nothing further.
- C. Confirm the presence of asbestos by laboratory evaluation. If asbestos is confirmed, call a certified engineer for expert assessment.
- D. Reassure the parents that the hazards of asbestos have been overstated.
Correct Answer: C
Rationale: Asbestos should be confirmed by laboratory testing, and if present, a certified engineer should assess the situation to determine the safest course of action.
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After receiving an immunization for pediatric diphtheria, tetanus, and acellular pertussis (DTaP), a patient develops swelling and tenderness at the injection site, a low-grade fever, and malaise. The pediatric nurse informs the patient's parents that:
- A. they should delay future immunizations until the patient sees an allergist.
- B. this is a mild reaction, and teaches them how to manage it.
- C. this is an appropriate reaction, and instructs them to do nothing.
- D. none of the above.
Correct Answer: B
Rationale: Mild reactions like swelling, tenderness, low-grade fever, and malaise are common after DTaP vaccination and can be managed with supportive care.
All the following are recognizable teratogens EXCEPT
- A. ethanol
- B. antiepileptic medications
- C. toxoplasmosis
- D. hypothermia
Correct Answer: D
Rationale: Hypothermia is not traditionally considered a teratogen compared to others listed.
Before a cancer receiving total parenteral nutrition (TPN) resumes a normal diet, the nurse teaches him about dietary sources of minerals. Which foods are good sources of zinc?
- A. Fruits and yellow vegetables
- B. Fruits and green vegetables
- C. Yeast and legumes
- D. Whole grains and meats
Correct Answer: D
Rationale: Zinc is an essential mineral that plays a crucial role in immune function, wound healing, and overall growth and development. Good dietary sources of zinc include whole grains and meats. Whole grains such as wheat and rice contain moderate amounts of zinc, while meats such as beef, pork, and chicken are rich sources of this mineral. Including these foods in the diet can help ensure an adequate intake of zinc, especially for individuals who have increased nutritional needs like cancer patients receiving TPN.
A nurse is assessing a child and notes Koplik spots. In which of these communicable diseases are Koplik spots present?
- A. Rubella
- B. Measles (rubeola)
- C. Chickenpox (varicella)
- D. Exanthema subitum (roseola)
Correct Answer: B
Rationale: Koplik spots are small white spots with a bluish-white center on the buccal mucosa (inside the cheeks). They are a characteristic finding in measles (rubeola) and are considered an early sign of the disease. Measles is a highly contagious viral infection that primarily affects children. In addition to Koplik spots, other symptoms of measles include fever, cough, runny nose, and a characteristic rash that typically starts on the face and spreads to the rest of the body. Vaccination is an effective way to prevent measles and its complications.
When caring for a 3 year old with tetralogy of Fallot, he nurse expects to see fatigue and poor activity tolerance. This is caused by:
- A. Poor muscle tone
- B. Inadequate oxygenation of tissues.
- C. Restricted blood flow leaving the heart
- D. Inadequate intake of food.
Correct Answer: B
Rationale: Tetralogy of Fallot is a heart defect that involves four specific abnormalities in the heart's structure. One of these abnormalities is a ventricular septal defect, which results in a mixing of oxygenated and deoxygenated blood. This leads to inadequate oxygenation of tissues because some of the blood that is pumped out to the body is not fully oxygenated. As a result, the child may experience fatigue and poor activity tolerance due to the reduced oxygen supply to the tissues and organs. This is why the nurse would expect to see these symptoms in a 3-year-old with tetralogy of Fallot.