Nokea
In administering vitamin K to the infant shortly after birth, the nurse understands that vitamin K is
- A. Synthesized by the kidneys
- B. Not initially synthesized because of sterile bowel at birth
- C. Given to enhance lung function
- D. Produced by the liver immediately
Correct Answer: B
Rationale: Not initially synthesized because of sterile bowel at birth B explains the need for vitamin K to prevent hemorrhagic disease, per document .
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What type of diet is recommended for the menopausal woman?
- A. Low-fat, high-fiber, and soy diet
- B. High-carbohydrate, low-fat diet
- C. Low-salt, high-fiber, low-protein diet
- D. Low-fat, low-carbohydrate, high-protein
Correct Answer: A
Rationale: A low-fat, high-fiber, and soy diet (A) helps manage menopausal symptoms via phytoestrogens and heart health. Other options (B, C, D) lack soy’s specific benefits. Document: 'A low-fat, high-fiber, and soy diet… [is used for] managing menopausal symptoms.'
A child with diabetes should be taught to recognize
- A. Shakiness
- B. Sweating
- C. Weakness
- D. All of the above
Correct Answer: D
Rationale: All D are hypoglycemia signs, per document p60, 9.
A 14-year-old boy appears with tall stature, long limbs, and a heart murmur. Echocardiogram reveals aortic root dilation. Most likely diagnosis is:
- A. Klinefelter syndrome
- B. Marfan syndrome
- C. Growth hormone excess
- D. Hyperthyroidism
Correct Answer: B
Rationale: Marfan syndrome fits tall stature, long limbs, and aortic dilation, per AAP (doc p151, Q606).
A nurse is caring for a child following surgical removal of a brain tumor. The nurse is monitoring the child and notes that the pulse rate has increased and the blood pressure has dropped significantly. Bloody drainage is also noted on the posterior dressing. The initial nursing action is to:
- A. Recheck the vital signs in 1 hour
- B. Place the child in Trendelenburg's position
- C. Document the findings
- D. Notify the registered nurse (RN)
Correct Answer: D
Rationale: Increased pulse, low BP, and bloody drainage suggest hemorrhage or ICP; notify RN (D) immediately. Waiting (A), Trendelenburg (B), or documenting only (C) delays care. Document: 'Most tumors create increased ICP… [requiring] immediate action.'
Immediate priority for a 6-year-old with pneumonia is
- A. Nutrition
- B. Medication
- C. Reassurance
- D. Rest
Correct Answer: D
Rationale: Rest D reduces respiratory demand, per document p18, 4.