Primary amenorrhea should be considered for any female adolescent who has not reached menarche by
- A. 13 years or has not done so within 3 years of thelarche
- B. 14 years or has not done so within 2 years of thelarche
- C. 14 years or has not done so within 3 years of thelarche
- D. 15 years or has not done so within 3 years of thelarche
Correct Answer: D
Rationale: Primary amenorrhea is suspected if menarche has not occurred by age 15 or within 3 years of thelarche.
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A 3-week-old neonate is brought to the emergency department because of a three-day history of intermittent vomiting. His mother reports that he has not urinated for eight hours. On physical examination, his eyes are sunken. Which of the following will MOST likely require correction before surgery is performed?
- A. Hypochloremia
- B. Hyperkalemia
- C. Hypernatremia
- D. N/A
Correct Answer: A
Rationale: Hypochloremia is often associated with dehydration and metabolic alkalosis, which may need correction before surgery.
Clients will go through operations and who have undergone surgery need the proper observation, treatment, and care. Implementing the nursing process to these patients will help reduce complications. Nurse Maria is preparing Mr. Sy for surgery. Which of the following statements by the client would indicate he is well-informed about his imminent surgery?
- A. " Right after the operation, I will wear the pneumatic compression device while sitting on the chair."
- B. "I will not eat anything after 12 pm the night befire my operation, but I sure can drink."
- C. "The skin preparation site is longer and wider than the actual incision site."
- D. "I will need to sign the consent from after I get to the operating table."
Correct Answer: B
Rationale: Option B, "I will not eat anything after 12 pm the night before my operation, but I sure can drink," indicates that the client understands and is knowledgeable about the pre-operative fasting guidelines. It is crucial for patients to have an empty stomach before surgery to prevent complications related to anesthesia, such as aspiration pneumonia. This statement shows that Mr. Sy is well-informed and compliant with this important pre-operative instruction. Options A, C, and D do not directly demonstrate specific knowledge regarding the surgery preparations.
Which is descriptive of bulimia during adolescence?
- A. Strong sense of control over eating behavior
- B. Feelings of elation after the binge-purge cycle
- C. Profound lack of awareness that the eating pattern is abnormal
- D. Weight that can be normal, slightly above normal, or below normal
Correct Answer: C
Rationale: During adolescence, individuals with bulimia often have a profound lack of awareness that their eating pattern is abnormal. This lack of awareness can be attributed to various factors, such as societal pressures, distorted body image, and the normalization of disordered eating behaviors within their social circle. Adolescents with bulimia may not recognize their behaviors as problematic or may rationalize them as a means of coping with stress or controlling their weight. This lack of insight can make it challenging for them to seek help or receive proper treatment for their condition.
Alveolar type of rhabdomyosarcoma accounts for approximately 1/3 of all cases of pediatric RMS and carries the poorest prognosis. Of the following, the MOST common site of involvement by alveolar type RMS is
- A. orbit
- B. middle ear
- C. extremities
- D. bladder
Correct Answer: C
Rationale: Extremities are the most common site for alveolar rhabdomyosarcoma.
The beta subunit of human chorionic gonadotropin (HCG) is a useful surface marker in some malignant germ cell tumors (GCTs); it is secreted by syncytiotrophoblasts. In which of the following GCTs this surface marker is characteristically elevated?
- A. teratoma
- B. germinoma
- C. endodermal sinus tumor
- D. embryonal carcinoma
Correct Answer: D
Rationale: Embryonal carcinoma is strongly associated with elevated beta-HCG levels.