Nokea
The differential in a 5-year old with a 2-week history of painful joints is all the following except:
- A. Viral polyarthritis
- B. Rheumatoid arthritis
- C. Lyme disease
- D. Rheumatic fever
Correct Answer: B
Rationale: rheumatoid arthritis is rare in a 5-year-old with a 2-week history of joint pain. The other options (a-d) are more likely differentials.
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A client is brought to the ED by ambulance in cardiac arrest with cardiopulmonary resuscitation (CPR) in progress. The client is intubated and is receiving 100% oxygen per self-inflating (ambu) bag. The nurse determines that the client is cyanotic, cold, and diaphoretic. Which assessment is most important for the nurse to obtain?
- A. Breath sounds over bilateral lung fields.
- B. Carotid pulsation during compressions
- C. Deep tendon reflexes
- D. Core body temperature
Correct Answer: A
Rationale: Assessing breath sounds ensures that the endotracheal tube is properly placed and that ventilation is effective, which is critical in a cardiac arrest situation.
The nurse is evaluating a male client’s understanding of diet teaching about the DASH (Dietary Approaches to Stop Hypertension) eating plan. Which behavior indicates that the client is adhering to the eating plan?
- A. Uses only lactose-free dairy products
- B. Enjoys fat free yogurt as an occasional snack food
- C. No longer includes grains in his daily diet
- D. Carefully cleans and peels all fresh fruit and vegetables
Correct Answer: D
Rationale: Cleaning and peeling fruits and vegetables is consistent with the DASH plan, which promotes a high intake of fresh produce.
Congenital complete heart block
- A. Corrected TGA
- B. SLE mother's child
- C. Plonged QT
- D. MgSO4 therapy to mother
Correct Answer: B
Rationale: Congenital complete heart block is often associated with mothers who have systemic lupus erythematosus.
The clinic nurse reviews the record of a child just seen by the health care provider and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder?
- A. Pallor
- B. Hyperactivity
- C. Exercise intolerance
- D. Gastrointestinal disturbances
Correct Answer: C
Rationale: Exercise intolerance is a common clinical manifestation of aortic stenosis due to the heart's inability to pump sufficient blood during increased physical activity.
What are FOUR possible differential diagnoses associated with aortopathy in a child, aside from Marfan’s?
- A. Ehlers-Danlos Syndrome (vascular type IV)
- B. Bicuspid aortic valve
- C. Takayasu Arteritis
- D. Unrepaired coarctation of the aorta
Correct Answer: A
Rationale: These are potential differential diagnoses associated with aortopathy in children, aside from Marfan’s syndrome, which is a common condition linked to aortic dilation.