Nokea
Signs of cold stress that the nurse must be alert when caring for a Newborn is:
- A. Hypothermia
- B. Decreased activity level
- C. Shaking
- D. Increased RR
Correct Answer: D
Rationale: Increased respiratory rate (RR) is a key sign of cold stress as the newborn attempts to compensate metabolically.
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A 19-year-old freshman in college presents with 'lumps' on the right side of his neck and in the right axilla. He had a fever to 39°C 1 day in the past week. On physical exam, there are firm anterior cervical and axillary nodes, all greater than 2 cm in diameter. A chest x-ray shows a large mediastinal mass. A biopsy of the axillary node reveals classic Hodgkin lymphoma. Which of the following symptoms revealed during the history is a B symptom?
- A. Fever to 39°C
- B. 10% weight loss in past 6 months
- C. Fatigue
- D. Alcohol-induced pain
Correct Answer: A
Rationale: B symptoms in Hodgkin lymphoma include fever (>38°C), night sweats, and unintentional weight loss (>10% in 6 months). Fever to 39°C qualifies as a B symptom, while fatigue and alcohol-induced pain are not.
What is the most likely diagnosis for a 2-year-old girl with blood in urine, intermittent abdominal pain, and a palpable mass in the right upper quadrant?
- A. Cystic nephroma
- B. Cystitis
- C. Neuroblastoma
- D. Wilms tumor
Correct Answer: D
Rationale: Wilms tumor presents with a renal mass, hematuria, and pain.
A 13-year-old is seen for a routine checkup. What is an expected emotional development milestone for this age?
- A. Developing strong attachments to caregivers.
- B. Experiencing self-conscious emotions and identity exploration.
- C. Demonstrating separation anxiety.
- D. Developing a sense of trust in relationships.
Correct Answer: B
Rationale: Adolescents explore identity and experience heightened self-consciousness, aligning with typical emotional development.
Which of the actions suggested to the RN by the PN during a planning conference for a 10 month-old infant admitted 2 hours ago with bacterial meningitis would be acceptable to add to the plan of care?
- A. Measure head circumference
- B. Place in airborne isolation
- C. Provide passive range of motion
- D. Provide an over-the-crib protective top
Correct Answer: A
Rationale: Measuring head circumference monitors for complications like hydrocephalus in meningitis.
During routine follow-up of a boy with spinal muscular atrophy (SMA) type 2, his mother informs you she is in a new relationship and 20 weeks pregnant with a male fetus. What is the risk the fetus will be affected?
- A. 1 in 2
- B. 1 in 4
- C. 1 in 50
- D. 1 in 200
Correct Answer: B
Rationale: SMA type 2 is autosomal recessive; with both parents as carriers (assumed from the affected child), the risk for each offspring is 1 in 4.