Nokea
In growing children, growth hormone deficiency results in short stature and very slow growth rates. Short stature may result from which of the following?
- A. Anterior pituitary gland hypofunction
- B. Posterior pituitary gland hyperfunction
- C. Parathyroid gland hyperfunction
- D. Thyroid gland hyperfunction
Correct Answer: A
Rationale: Short stature due to growth hormone deficiency commonly occurs as a result of anterior pituitary gland hypofunction. The anterior pituitary gland is responsible for releasing growth hormone, which is crucial for proper growth and development, especially during childhood. When there is a deficiency of growth hormone, children may experience slowed growth rates and ultimately result in short stature. Other gland dysfunctions mentioned in the choices, such as posterior pituitary gland hyperfunction, parathyroid gland hyperfunction, and thyroid gland hyperfunction, do not directly impact growth hormone production and are not associated with growth hormone deficiency-related short stature in children.
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An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago. She has not received any medical care. She smokes but denies any other substance use. What is the priority nursing action?
- A. Notify her parents
- B. Refer for prenatal care
- C. Explain the importance of not smoking
- D. Discuss dietary needs for adequate fetal growth
Correct Answer: B
Rationale: The priority nursing action in this situation is to refer the adolescent for prenatal care. Prenatal care is crucial for monitoring the health of both the mother and the baby throughout the pregnancy. This includes assessing for any potential complications, providing appropriate interventions, and ensuring proper support for a healthy pregnancy. It is important for the adolescent to receive medical care as soon as possible to optimize the outcomes for both her and her baby. While notifying her parents, explaining the importance of not smoking, and discussing dietary needs are also important aspects of care, ensuring timely access to prenatal care is the most critical priority in this scenario.
The nurse has determined the rate of both the child's radial pulse and heart. What is the normal finding when comparing the two rates?
- A. Are the same
- B. Differ, with heart rate faster
- C. Differ, with radial pulse faster
- D. Differ, depending on quality and intensity
Correct Answer: A
Rationale: In a normal healthy individual, the rate of the radial pulse (peripheral pulse) and the heart rate (apical pulse) should be the same. This is because each heartbeat should result in a corresponding pulse felt at the radial artery in the wrist. The pulse is generated by the heart's contraction and the subsequent ejection of blood into the arteries, causing a wave of pressure that can be felt as the pulse. Therefore, in a healthy individual, the radial pulse rate should match the heart rate. If there is a significant difference between the two rates, it may indicate a cardiovascular abnormality or other underlying health condition that warrants further investigation.
You are discussing failure to thrive (FTT) with medical students. You mention that FTT is most often used to describe malnutrition related to environmental or psychosocial causes. An important statement that should be included in your discussion is
- A. FTT is often diagnosed by weight that falls below the 25th percentile for age
- B. a weight crossing one major percentile lines on the growth height should be evaluated for FTT chart over time is considered abnormal
- C. a weight of less than 60 % of the median weight for the height of the child
- D. small subset of the population naturally falls below the 3rd percentile but usually have normal weight for height
Correct Answer: B
Rationale: Crossing percentile lines on a growth chart indicates a significant deviation from the child's previous growth trajectory, which is a key indicator of potential FTT.
the frontal fontanell is protruding when a child suffering from:
- A. meningitis
- B. hydrocepalus
- C. subdural hematoma
- D. all the answers are correct
Correct Answer: D
Rationale: The protrusion of the frontal fontanelle in a child can be a concerning sign and can be seen in various conditions such as meningitis, hydrocephalus, and subdural hematoma. In meningitis, the inflammation of the meninges can lead to increased intracranial pressure, which may cause the fontanelle to bulge. Hydrocephalus, which is the buildup of fluid in the brain, can also result in the fontanelle being more pronounced. Additionally, a subdural hematoma, which is a collection of blood between the brain and its outermost covering, can lead to pressure on the brain and consequent fontanelle protrusion. Therefore, all the provided choices (A, B, C) are correct as they can lead to the protrusion of the frontal fontanelle in a child.
A nurse is teaching parents about caring for their child with chickenpox. The nurse should let the parents know that the child is considered to be no longer contagious when which occurs?
- A. When fever is absent
- B. When lesions are crusted
- C. 24 hours after lesions erupt
- D. 8 days after onset of illness
Correct Answer: B
Rationale: The child with chickenpox is considered to be no longer contagious when the lesions are crusted over. This usually occurs around 7-10 days after the rash first appears. At this stage, the fluid-filled blisters have dried up and formed scabs, indicating that the infectious stage of the illness has passed. The child can then safely return to school or daycare without posing a risk of spreading the infection to others. It is important for parents and caregivers to continue practicing good hygiene and ensuring that the child does not scratch the scabs to prevent complications and scarring.