Burns Pediatric Primary Care Test Bank

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the clinical manifestations of nephrosis include which of the following ?

  • A. hematuria, bacteriuria, weight gain.
  • B. gross hematuria, albuminuria, fever.
  • C. hypertension, weight loss, proteinuria.
  • D. massive proteinuria, hypoalbuminemia, edema.
Correct Answer: D

Rationale: Nephrosis, also known as nephrotic syndrome, is characterized by the presence of massive proteinuria (excretion of more than 3.5 grams of protein in the urine per day), hypoalbuminemia (low levels of albumin in the blood), and edema (swelling due to fluid retention). These are the hallmark clinical manifestations of nephrosis. Proteinuria results from damage to the glomerular filtration barrier, leading to the loss of proteins, particularly albumin, in the urine. Hypoalbuminemia occurs due to the excessive loss of albumin in the urine, leading to reduced oncotic pressure in the bloodstream. Edema develops as a result of decreased oncotic pressure, which causes fluid to leak from the blood vessels into the tissues, especially in the lower extremities and around the eyes. Other common manifestations of nephrosis may include hyperlipidemia, lipid

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Idiopathic thrombocytopenic purpura (ITP) commonly results in what finding?

  • A. Blood clots
  • B. Pallor
  • C. Dry membranes
  • D. Bruising
Correct Answer: D

Rationale: Idiopathic thrombocytopenic purpura (ITP) is a condition characterized by a low platelet count, leading to an increased risk of bleeding and easy bruising. Platelets are responsible for blood clotting and when their count is low, it can result in purpura (bruising) due to small blood vessels leaking blood into the skin. For this reason, the most common finding in ITP is bruising rather than blood clots, pallor, or dry membranes.

Newborns are highly susceptible to infection as a result of:

  • A. excessive levels of immunoglobulin A (IgA) and immunoglobulin M (IgM).
  • B. diminished nonspecific and specific immunity.
  • C. increased humoral immunity.
  • D. overwhelming anti-inflammatory response.
Correct Answer: B

Rationale: Newborns are highly susceptible to infection due to their diminished nonspecific and specific immunity. Nonspecific immunity includes physical barriers such as intact skin and mucous membranes, as well as components of the innate immune system like phagocytes and complement proteins. Specific immunity refers to the adaptive immune response involving B and T cells. In newborns, both these arms of the immune system are not fully developed or mature, leading to increased susceptibility to infections. Additionally, newborns have lower levels of immunoglobulins like IgA and IgM compared to adults, further contributing to their vulnerability to infections.

Aling Nena, 68 years old, had a MVA and underwent surgery for hip fracture. Two days post-surgery, she suddenly complained of chest heaviness despite the absence of cardiac history. What is the nursing priority?

  • A. document the onset, duration, severity, and precipitating factors
  • B. may offer analgesics for chest pain
  • C. administer oxygen via face mask
  • D. inform the physician about the heaviness
Correct Answer: C

Rationale: In a post-operative patient, sudden chest heaviness can be a sign of various complications, such as a pulmonary embolism or cardiac issue. One of the immediate nursing interventions for a patient complaining of chest heaviness is to ensure adequate oxygenation. Administering oxygen via a face mask can help improve oxygenation and provide relief while further assessments are being done to determine the cause of the symptom. This intervention takes priority over documenting the symptom, offering analgesics, or informing the physician, as addressing the patient's oxygen needs is crucial in this situation.

Which of the following is an adverse reaction to glipizide (Glucotrol)?

  • A. Headache
  • B. Hypotension
  • C. Constipation
  • D. Photosensitivity
Correct Answer: B

Rationale: Hypotension, which is low blood pressure, can be an adverse reaction to glipizide (Glucotrol). Glipizide is a medication used to treat type 2 diabetes by helping to control blood sugar levels. Hypotension could occur as a side effect of glipizide, causing symptoms such as dizziness, lightheadedness, and fainting. If a patient experiences hypotension while taking glipizide, medical attention should be sought immediately to address this potentially serious adverse reaction.

Which vein should be used first when initiating IV therapy?

  • A. Jugular
  • B. Basilic
  • C. Brachiocephalic
  • D. Axillary
Correct Answer: B

Rationale: When initiating IV therapy, the basilic vein is often used first due to its accessibility and size. The basilic vein is a common choice for venipuncture because it is located on the medial aspect of the arm and tends to be easily palpable. Additionally, the basilic vein is also less prone to complications such as nerve damage compared to other deeper veins like the jugular or brachiocephalic veins. Therefore, utilizing the basilic vein as the initial site for IV therapy is a safe and efficient choice.

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