Nokea
Nurse Veronica is teaching a group of parents about otitis media. When discussing why children are predisposed to this disorder, the nurse should mention the significance of which anatomical feature?
- A. Nasopharynx
- B. Eustachian tubes
- C. External ear canal
- D. Tympanic membrane 51
Correct Answer: B
Rationale: The Eustachian tubes are small passages that connect the middle ear to the back of the throat. In young children, these tubes are shorter, more horizontal, and more narrow than in adults, making them more prone to blockages and infections. When these tubes become blocked, usually due to factors like swelling from allergies or a cold, fluid can build up in the middle ear leading to otitis media or middle ear infection. Therefore, the anatomy and size of the Eustachian tubes play a significant role in the predisposition of children to otitis media.
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The primary critical observation for Apgar scoring is the:
- A. Heart rate
- B. Respiratory rate
- C. Presence of meconium
- D. Evaluation of the Moro reflex
Correct Answer: A
Rationale: The primary critical observation for Apgar scoring is the heart rate. This is because the heart rate is vital for life and immediate assessment of the infant's heart rate provides crucial information about the baby's overall well-being and response to the birthing process. The Apgar score assesses five components: heart rate, respiratory effort, muscle tone, reflex irritability, and skin color. Among these components, the heart rate is considered the most critical because it directly reflects the infant's cardiovascular status and their ability to maintain adequate perfusion of vital organs. Therefore, for quick assessment and immediate intervention, the heart rate is prioritized as the primary observation in Apgar scoring.
A child is diagnosed with Wilms' tumor. During assessment, the nurse in charge expects to detect:
- A. Gross hematuria
- B. Dysuria
- C. Nausea and vomiting
- D. An abdominal mass
Correct Answer: D
Rationale: In a child with Wilms' tumor, the nurse would expect to detect an abdominal mass upon assessment. Wilms' tumor, also known as nephroblastoma, is a type of kidney cancer that commonly presents as a firm, non-tender abdominal mass. This mass may be felt upon palpation of the abdomen. Gross hematuria (A) is not a typical finding associated with Wilms' tumor. Dysuria (B) is the term used to describe painful or difficult urination and is not a characteristic symptom of Wilms' tumor. Nausea and vomiting (C) are also not commonly associated with Wilms' tumor, unless the tumor is causing obstruction or compression of nearby structures in the abdomen.
Use of condoms of those found to be infected with HIV
- A. 1 & 3
- B. 3 & 4
- C. 2 & 3 SITUATION; Mr. Baldo , 36 years old patient complaints of fatigue, weight loss, and low-grade fever. He also has pa in his fingers, elbows, and ankles.
Correct Answer: B
Rationale: In the given scenario involving Mr. Baldo presenting with symptoms of fatigue, weight loss, low-grade fever, and joint pain in fingers, elbows, and ankles, it is suggested that he may potentially have rheumatoid arthritis. Therefore, options 3 and 4 are the correct choices. Option 3 mentions the administration of NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) for pain management, which is a common treatment approach for rheumatoid arthritis to help reduce inflammation and manage pain. Option 4 suggests consulting a rheumatologist for further evaluation and management, which is crucial in determining the appropriate diagnosis and treatment plan for Mr. Baldo's condition.
An 8-day-old is admitted with vomiting and dehydration. His HR is 170, RR is 44, BP is 85/52, and T is 99°F. The parents ask if these vital signs are normal. Which is the best response?
- A. The BP is elevated.
- B. The temperature is elevated.
- C. The heart rate is elevated; normal for a neonate is 90-160 bpm.
- D. The respiratory rate is elevated.
Correct Answer: C
Rationale: A neonatal heart rate of 170 is above the normal range (90-160 bpm), which is concerning for dehydration.
A 10-mo-old boy has a left suprarenal mass. Surgery is accomplished with complete removal of the mass as well as the non-adherent lymph nodes; surgical biopsies are taken during surgery. The histology reveals poorly differentiated neuroblastoma with microscopic ipsilateral lymph nodes involvement. The contralateral lymph nodes are negative. Of the following, the BEST therapeutic approach for this infant is
- A. chemotherapy
- B. radiotherapy
- C. concomitant chemo-radiotherapy
- D. chemotherapy followed by radiotherapy
Correct Answer: A
Rationale: Complete resection with microscopic residual disease typically warrants adjuvant chemotherapy.