Nokea
Features that would increase suspicion of cerebral palsy at age 9 months include:
- A. Presence of Moro reflex
- B. Abductor spasm
- C. Hand dominance
- D. Grasp reflex
Correct Answer: C
Rationale: Hand dominance at 9 months is a red flag for cerebral palsy. The persistence of primitive reflexes like the Moro and grasp reflexes can also be indicative.
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The routine investigation of a 4-year-old with an uncomplicated UTI involves:
- A. Renal ultrasound scan
- B. Micturating cystogram
- C. DMSA (dimercaptosuccinic acid) scan
- D. DTP scan
Correct Answer: A
Rationale: A renal ultrasound scan is a standard initial investigation for a child with an uncomplicated UTI to assess for structural abnormalities.
Concerning tetanus:
- A. The infection is usually fatal
- B. The muscle spasms are often localized
- C. Immunization confers lifelong immunity
- D. Incubation period is usually weeks
Correct Answer: C
Rationale: Immunization with the tetanus toxoid provides long-lasting immunity, though booster shots are recommended to maintain protection.
Acute bronchiolitis is associated with:
- A. A higher incidence in infants than in school children
- B. The production of copious amounts of purulent sputum
- C. Widespread fine crackles
- D. A polymorphonuclear leucocytosis
Correct Answer: A
Rationale: Acute bronchiolitis is more common in infants and is associated with fine crackles. Purulent sputum and polymorphonuclear leucocytosis are not typical features.
A client with cancer is receiving chemotherapy with a known vesicant. The client's IV has been in place for 72 hours. The nurse determines that a new IV site cannot be obtained, and leaves the present IV in place. What is the greatest clinical risk related to this situation?
- A. Impaired skin integrity
- B. Fluid volume excess
- C. Acute pain and anxiety
- D. Peripheral neurovascular dysfunction
Correct Answer: A
Rationale: Vesicants can cause severe tissue damage if they extravasate, leading to impaired skin integrity.
An older adult man recently diagnosed with chronic obstructive pulmonary disease (COPD) is admitted with shortness of breath. The nurse observes the client sitting upright and leaning over the bedside table, using accessory muscles to assist in breathing. What action should the nurse take?
- A. Assist the client to a high Fowler's position in bed
- B. Observe the client for the presence of a barrel chest
- C. Prepare to transfer the client to a critical care unit
- D. Instruct the client in pursed lip breathing techniques
Correct Answer: D
Rationale: Pursed lip breathing helps reduce dyspnea and improves oxygenation in clients with COPD.