Nokea
How would you classify a child at two years of age who has fast breathing without chest indrawing or stridor when calm?
- A. Very severe disease
- B. Pneumonia
- C. No pneumonia
- D. Local infection
Correct Answer: B
Rationale: In pediatric clinical assessment, a child at two years of age with fast breathing but without chest indrawing or stridor when calm is classified as having pneumonia. Fast breathing in this context is a key symptom used in the Integrated Management of Childhood Illness (IMCI) guidelines to diagnose pneumonia in children under five years old. The absence of chest indrawing or stridor when the child is calm helps differentiate this case from other respiratory conditions, making pneumonia the likely classification. Choices A, C, and D are incorrect. 'Very severe disease' is too broad and not specific to the symptoms described. 'No pneumonia' is also incorrect as the symptoms match the presentation of pneumonia. 'Local infection' is too vague and does not specifically address the respiratory symptoms observed.
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Where is the most appropriate location to perform a procedure on a preschooler?
- A. Perform the procedure in the child's hospital bed.
- B. Perform the procedure in the treatment room.
- C. Allow the child to decide when the procedure will be performed.
- D. Ask the parents to help restrain the child so the procedure can be performed.
Correct Answer: B
Rationale: When performing a procedure on a preschooler, it is most appropriate to do so in the treatment room. This setting is specifically designed to provide a suitable environment with necessary equipment and resources to ensure the procedure is carried out safely and efficiently. It helps minimize distractions and provides a controlled environment for healthcare providers to focus on the child's needs. Choices A, C, and D are incorrect because performing the procedure in the child's hospital bed may lack the necessary resources and equipment, allowing the child to decide when the procedure will be performed may not be feasible due to medical necessity and urgency, and asking parents to help restrain the child is not ideal as it may not provide a professional and controlled setting for the procedure.
When does the rash in typhoid fever typically appear?
- A. On the second day after symptoms appear
- B. On the third day after symptoms appear
- C. On the fourth day after symptoms appear
- D. On the seventh day after symptoms appear
Correct Answer: B
Rationale: In typhoid fever, the rash typically appears on the third day after symptoms first appear. This rash can help in diagnosing the disease along with other symptoms such as fever, malaise, and abdominal pain. Choices A, C, and D are incorrect because the rash in typhoid fever usually appears on the third day, not the second, fourth, or seventh day after the symptoms begin.
A mother visited your facility with the complaint of her child passing watery stools for two days. This is the first time the child is having such an experience. How will you describe such a visit?
- A. Initial
- B. Follow-up
- C. Routine visit
- D. None of the above
Correct Answer: A
Rationale: The correct answer is 'Initial.' This visit is described as initial because it is the first time the child is experiencing these symptoms. It signifies the first encounter with healthcare professionals for this specific issue, distinguishing it from subsequent visits which would be follow-up appointments to monitor progress or routine visits for preventive care. Choice B, 'Follow-up,' is incorrect as it implies subsequent visits after the initial encounter. Choice C, 'Routine visit,' is also incorrect as it implies a scheduled visit for preventive care rather than a visit prompted by a new or acute issue. Choice D, 'None of the above,' is incorrect as one of the options accurately describes the situation, which is 'Initial.'
A 3-month-old is hospitalized with a fractured femur. The pain assessment tool most appropriate for this child is the:
- A. FLACC scale.
- B. Poker chip tool.
- C. Number scale.
- D. Visual analog scale.
Correct Answer: A
Rationale: The FLACC scale is a validated pain assessment tool suitable for infants and young children, including 3-month-olds. It assesses pain based on five categories: Face, Legs, Activity, Cry, and Consolability. Since infants cannot communicate their pain verbally, the FLACC scale is effective in evaluating pain by observing these behavioral indicators. The other options, such as the Poker chip tool, Number scale, and Visual analog scale, are not specifically designed for infants and may not provide accurate pain assessment in this age group.
The mother of an 11-year-old girl confides to the nurse that her child has no interest in school activities, exercise, or even family outings. The most appropriate response by the nurse would be:
- A. I would recommend that she see a counselor at school.
- B. I would not worry; she will grow out of it.
- C. Many girls this age go through a time of malaise and disinterest.
- D. If she still feels the same way when you come back for the next well-child visit, I will recommend a therapist.
Correct Answer: A
Rationale: When a child shows a lack of interest in various activities, including school, exercise, and family outings, it is essential to address the underlying reasons. Recommending that the child see a counselor at school is crucial to explore potential issues and provide appropriate support and guidance. This approach can help identify any emotional, social, or behavioral concerns the child may be experiencing and facilitate early intervention and support. Choice B is incorrect because dismissing the mother's concerns and assuming the child will grow out of it without addressing the issue is not appropriate. Choice C is incorrect because while some children may go through phases of disinterest, it is essential to investigate further rather than generalizing. Choice D is incorrect because waiting until the next visit without taking proactive steps to address the current lack of interest may delay necessary support and intervention.