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Nurse Kai is evaluating a female child with acute post-streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?
- A. Increased urine output
- B. Increased appetite
- C. Increased energy level
- D. Decreased diarrhea
Correct Answer: A
Rationale: In a female child with acute post-streptococcal glomerulonephritis, the earliest sign of improvement is often seen as an increase in urine output. This occurs as the kidneys start to recover and normal functioning is restored. Increased urine output indicates improved glomerular filtration and clearance of waste products from the body. It is an essential indicator of renal function and overall improvement in the condition of the child. Other signs such as increased appetite and energy levels may follow but increased urine output is typically the first noticeable sign of improvement in cases of glomerulonephritis.
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During a routine health assessment, the nurse notes that an 8-month-old infant has significant head lag. Which is the nurse's most appropriate action?
- A. Teach parents appropriate exercises.
- B. Recheck head control at next visit.
- C. Refer child for further evaluation.
- D. Refer child for further evaluation if anterior fontanel is still open. TestBankWorld.org
Correct Answer: C
Rationale: Significant head lag in an 8-month-old infant can be a concerning sign indicating potential developmental delays or muscle weakness. The most appropriate action for the nurse in this situation is to refer the child for further evaluation by a healthcare provider, such as a pediatrician or developmental specialist, to assess and address the underlying cause of the head lag. It is important to rule out any potential developmental issues early on to provide the necessary interventions and support for the infant's optimal growth and development.
You are explaining the risk of leukemia in children with Down syndrome to medical students; your discussion will include all the following statements EXCEPT
- A. acute leukemia occurs more frequently in children with Down syndrome than in the general population
- B. AML is more common in children with Down syndrome as compared to ALL
- C. children with Down syndrome have a slightly inferior outcome ratio of ALL/AML in general
- D. children with Down syndrome who develop AML demonstrate remarkable sensitivity to antimetabolites
Correct Answer: C
Rationale: Children with Down syndrome often have better outcomes when treated with specific regimens, contrary to this option.
At a public health fair, the nurse teaches a group of women about breast cancer awareness. Possible signs of breast cancer include:
- A. Fever.
- B. Nipple discharge and a breast nodule.
- C. Breast changes during menstruation.
- D. Fever and erythema of the breast.
Correct Answer: B
Rationale: Possible signs of breast cancer include nipple discharge (especially if it is bloody) and a breast nodule or lump that can be felt. It is important to note any changes in the breasts and report them to a healthcare provider for evaluation. Fever, breast changes during menstruation, and erythema of the breast are not typically associated with breast cancer. It is essential for women to perform regular breast self-exams and seek medical attention if they notice any unusual changes in their breast tissue.
A 5-year old girl presents to ER with fever, convulsions and unconsciousness of one day duration. On examination she is pale, Glasgow coma scale is 8 and there are no signs of meningial irritation and no focal neurological signs. The most likely diagnosis is:
- A. Viral encephalitis
- B. Pyomeningitis
- C. Tuberculous meningitis
- D. Cerebral malaria
Correct Answer: D
Rationale: Cerebral malaria can cause fever, seizures, altered consciousness, and normal cerebrospinal fluid findings without focal neurological signs.
A preschool child is being admitted to the hospital with dehydration and a urinary tract infection (UTI). Which urinalysis result should the nurse expect with these conditions?
- A. WBC <1; specific gravity 1.008
- B. WBC <2; specific gravity 1.025
- C. WBC >2; specific gravity 1.016
- D. WBC >2; specific gravity 1.030
Correct Answer: C
Rationale: When a child is admitted to the hospital with dehydration and a urinary tract infection (UTI), the urinalysis result that the nurse should expect is an increased white blood cell (WBC) count, indicated by WBC >2, along with a slightly elevated specific gravity, typically around 1.016. A specific gravity of 1.016 suggests some concentration of urine due to dehydration, while an increased WBC count indicates the presence of infection in the urinary tract. These findings are consistent with dehydration and UTI in a preschool child. Options A, B, and D do not fully align with the expected urinalysis results in this clinical scenario.