Nokea
The best growth chart indicator in patients with acute malnutrition is:
- A. Body mass index (BMI)
- B. Body weight
- C. Weight-for-height
- D. Head circumference
Correct Answer: C
Rationale: Weight-for-height best detects acute malnutrition (wasting), per WHO. BMI is less specific in kids, and B-D assess other aspects.
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A child with a history of cystic fibrosis suddenly develops right-sided chest pain and shortness of breath. Physical examination reveals decreased breath sounds on the right side and mediastinal shift to the left side. Most likely diagnosis is:
- A. Pneumonia
- B. Asthma exacerbation
- C. Foreign body aspiration
- D. Pneumothorax
Correct Answer: D
Rationale: Pneumothorax matches unilateral findings and mediastinal shift in cystic fibrosis, per CFF. A-C, E don’t fit.
A 6-month-old infant presents with wheezing and tachypnea. Chest x-ray shows perihilar infiltrates. Most likely diagnosis is:
- A. Pneumonia
- B. Bronchiolitis
- C. Cystic fibrosis
- D. Asthma
Correct Answer: B
Rationale: Bronchiolitis features wheezing and perihilar infiltrates, per AAP. A, C-E differ.
What type of diet is recommended for the menopausal woman?
- A. Low-fat, high-fiber, and soy diet
- B. High-carbohydrate, low-fat diet
- C. Low-salt, high-fiber, low-protein diet
- D. Low-fat, low-carbohydrate, high-protein
Correct Answer: A
Rationale: A low-fat, high-fiber, and soy diet (A) helps manage menopausal symptoms via phytoestrogens and heart health. Other options (B, C, D) lack soy’s specific benefits. Document: 'A low-fat, high-fiber, and soy diet… [is used for] managing menopausal symptoms.'
A nurse is caring for a child following surgical removal of a brain tumor. The nurse is monitoring the child and notes that the pulse rate has increased and the blood pressure has dropped significantly. Bloody drainage is also noted on the posterior dressing. The initial nursing action is to:
- A. Recheck the vital signs in 1 hour
- B. Place the child in Trendelenburg's position
- C. Document the findings
- D. Notify the registered nurse (RN)
Correct Answer: D
Rationale: Increased pulse, low BP, and bloody drainage suggest hemorrhage or ICP; notify RN (D) immediately. Waiting (A), Trendelenburg (B), or documenting only (C) delays care. Document: 'Most tumors create increased ICP… [requiring] immediate action.'
A 3-year-old with a head injury should be monitored for
- A. Pupil response
- B. Breathing
- C. Consciousness
- D. All of the above
Correct Answer: D
Rationale: All D assess head injury, per document p47, 0.