Nokea
During physical assessment of a 4-month-old infant with Hirschsprung's disease, the nurse should most likely note which of the following?
- A. Scaphoid-shaped abdomen.
- B. Weight less than expected for height and age.
- C. Cyanosis of the fingers and toes.
- D. Hyperactive deep tendon reflexes.
Correct Answer: B
Rationale: Hirschsprung's disease can lead to poor weight gain due to bowel obstruction.
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A nurse is reviewing a hospital's protocol for managing pediatric ingestions. Which step should be prioritized in the protocol?
- A. Administer an antidote immediately.
- B. Obtain a detailed history of the ingestion.
- C. Perform a physical examination.
- D. Order laboratory tests.
Correct Answer: B
Rationale: A detailed history (substance, amount, time) guides management decisions. Antidotes, exams, or labs follow based on history findings.
A 6-month-old child is discharged with a urinary stent after a procedure to repair a hypospadias. The nurse should tell the parents to:
- A. Avoid tub baths until the stent is removed.
- B. Measure output in the urinary bag.
- C. Avoid drinking fruit juice.
- D. Clean the tip of the penis 3 times a day with soap and water.
Correct Answer: A
Rationale: Avoiding tub baths prevents infection.
Which sign should lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation?
- A. Hemorrhagic skin rash.
- B. Edema.
- C. Cyanosis.
- D. Dyspnea on exertion.
Correct Answer: A
Rationale: A hemorrhagic rash, such as petechiae or purpura, is a hallmark of disseminated intravascular coagulation in meningitis, indicating clotting abnormalities.
What is the most appropriate method to use when drawing blood from a child with hemophilia?
- A. Use finger punctures for lab draws.
- B. Be prepared to administer platelets for prolonged bleeding.
- C. Apply heat to the extremity before venipunctures.
- D. Schedule all labs to be drawn at one time.
Correct Answer: D
Rationale: Scheduling labs together minimizes venipunctures, reducing bleeding risk in hemophilia. Finger punctures and heat increase bleeding, and platelets are not standard.
Which of the following structures should be closed by the time the child is 2 months old?
- A. A.
- B. B.
- C. C.
- D. D.
Correct Answer: C
Rationale: posterior fontanelle closes by 2 months.