Nokea
During a routine examination of a 10-mo-old male infant, you find a white pupillary reflex of the right eye; the eye movements are normal. You suspect retinoblastoma. Of the following, the BEST confirmatory diagnostic evaluation of this infant is
- A. indirect ophthalmoscopy with slit-lamp examination
- B. examination under general anesthesia by an experienced ophthalmologist
- C. orbital ultrasonography
- D. brain MRI
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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In an immunization clinic, which patient will the nurse identify as not eligible to receive routine immunizations?
- A. An 8-year-old experiencing diarrhea
- B. A 2-year-old with a history of pre-term birth
- C. A 4-year-old with a fever and upper respiratory tract infection
- D. A 6-year-old who has been recently exposed to a classmate with chickenpox
Correct Answer: C
Rationale: The nurse should identify the 4-year-old with a fever and upper respiratory tract infection as not eligible to receive routine immunizations. It is contraindicated to administer vaccines in the presence of moderate to severe illness, whether with or without fever, to prevent potential complications or reduced vaccine efficacy.
During the routine exam of an infant the parents state a 5th degree family history of adenomatous polyposis. The statement that should be included during the discussion is the infant is at increased risk of colonic adenocarcinoma
- A. the infant is at increased risk of acute lymphocytic leukemia
- B. the infant is at increased risk of intestinal Burkitt lymphoma
- C. the infant is at increased risk of hepatoblastoma
- D. the infant is at increased risk of germ cell tumor
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
At what age may an infant close their eyes to bright lights and show improved head control?
- A. 30-33 weeks after conception
- B. 34-36 weeks after conception
- C. Less than 30 weeks after conception
- D. 37-40 weeks after conception
Correct Answer: A
Rationale: Around 30-33 weeks after conception, infants usually start closing their eyes in response to bright lights and exhibit enhanced head control. This developmental milestone indicates progress in their visual and motor abilities, reflecting the maturation of their neurological system. As preterm infants continue to grow and develop, they gradually acquire these skills, showcasing the natural progression of their sensory and motor functions.
A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?
- A. Elevate the head of the child's bed
- B. Insert a large-bore IV catheter for the child
- C. Determine the allergen that caused the child's reaction
- D. Administer IM epinephrine to the child
Correct Answer: D
Rationale: In the management of anaphylaxis, the priority action for the nurse is to administer IM epinephrine to the child. Epinephrine is the first-line treatment for anaphylaxis as it helps reverse the severe manifestations of the reaction by constricting blood vessels, relaxing airway muscles, and decreasing hives and swelling. Elevating the head of the child's bed may be beneficial for respiratory distress but is not the priority over administering epinephrine. Inserting a large-bore IV catheter may be necessary for fluid resuscitation but is not the initial priority. Identifying the allergen is important for prevention and future management but is not the immediate action needed in the acute phase of an anaphylactic reaction.
A 2-mo-old male infant has a left flank mass discovered incidentally by the mother; radiological imaging reveals a left renal mass. Of the following, the MOST likely diagnosis is
- A. nephroblastoma
- B. neuroblastoma
- C. mesoblastic nephroma
- D. clear cell sarcoma
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.