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Sheena, tells the nurse that she wants to begin toilet training her 22-month-old child. The most important factor for the nurse to stress to the mother is:
- A. Developmental readiness of the child
- B. Consistency in approach
- C. The mother’s positive attitude
- D. Developmental level of the child’s peers
Correct Answer: A
Rationale: Developmental readiness is crucial for successful toilet training, as forcing it before the child is ready can lead to resistance and setbacks.
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Nurse Oliver s teaching a mother who plans to discontinue breast-feeding after 5 months. The nurse should advise her to include which foods in her infant’s diet?
- A. Iron-rich formula and baby food
- B. Whole milk and baby food
- C. Skim milk and baby food
- D. Iron-rich formula only
Correct Answer: A
Rationale: Iron-rich formula and baby food provide essential nutrients for a 5-month-old infant transitioning from breastfeeding.
A 5-year-old child who had a repair for transposition of the great arteries shortly after birth is growing normally and has been asymptomatic since the surgery. The primary care nurse practitioner notes mild shortness of breath with exertion and dizziness. What will the nurse practitioner do?
- A. Order an echocardiogram and chest radiograph.
- B. Perform pulmonary function testing.
- C. Reassure the parent that these symptoms are common.
- D. Refer the child to the cardiologist immediately.
Correct Answer: D
Rationale: Children with a history of transposition of the great arteries (d-TGA) who have a history of palpitations, syncope, or shortness of breath should be referred to a cardiologist.
The radiographic finding of notching of the ribs is associated with
- A. pulmonary hypertension
- B. anomalous pulmonary venous return above the diaphragm
- C. coarctation of the aorta
- D. systemic hypertension
Correct Answer: C
Rationale: Rib notching is a classic radiographic sign of coarctation of the aorta due to collateral vessel development.
Recognised diagnoses of tender scrotal swelling in infancy include:
- A. Inguinal hernia
- B. Epididymo-orchitis
- C. Breech delivery
- D. Torsion of testis
Correct Answer: D
Rationale: Torsion of the testis is a medical emergency and a common cause of tender scrotal swelling in infancy. Inguinal hernia and epididymo-orchitis are also possible but less urgent. Breech delivery is unrelated.
A 3-year-old child with a fever and sore throat is most likely to have:
- A. Coxsackievirus infection
- B. Tonsillitis
- C. Scarlet fever
- D. Measles
Correct Answer: B
Rationale: Tonsillitis is a common cause of fever and sore throat in young children and may be viral or bacterial in origin.