Nokea
The following statements are true:
- A. Unexplained vaginal discharge in a 3-year-old might be a sign of sexual abuse
- B. Spiral fracture of femur is always non-accidental
- C. Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome
- D. Bruises on the elbows and knees in a 4-year-old are suggestive of physical abuse
Correct Answer: C
Rationale: Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome: Retinal bleeding in infants, especially with other signs of physical abuse, is a key indicator of 'shaken baby' syndrome.
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Fetal distress is indicated by:
- A. Meconium staining of liquor
- B. Arrhythmias
- C. Tachycardia
- D. Bradycardia
Correct Answer: D
Rationale: The correct answer is D because bradycardia is a key indicator of fetal distress. The other options (a, b, c, e) are less specific or not primary indicators.
The nurse is teaching the importance of an exercise regime that includes walking daily for a group of clients with asthma, chronic bronchitis, and emphysema at a pulmonary rehabilitation clinic. Which rationale should the nurse include when motivating the clients?
- A. Daily exercise and walking enhances cardiovascular fitness
- B. Exercise eliminates the need for bronchodilator medications.
- C. Walking daily reverses lung damage caused by chronic conditions.
- D. Physical activity increases mucus production to clear airways.
Correct Answer: A
Rationale: Regular exercise improves cardiovascular fitness, which can enhance overall respiratory function and quality of life in clients with chronic pulmonary conditions.
Family discharge teaching has been effective when the parent of a toddler diagnosed with Kawasaki disease (KD) states:
- A. The arthritis in her knees is permanent. She will need knee replacements.
- B. I will give her diphenhydramine (Benadryl) for her peeling palms and soles of her feet.
- C. I know she will be irritable for 2 months after her symptoms start.
- D. I will continue with high doses of Tylenol for her inflammation.
Correct Answer: C
Rationale: This statement indicates the parent understands that irritability may persist for about 2 months after symptom onset in KD.
Common causes of recurrent haematuria are:
- A. Berger's disease
- B. Goodpasture's syndrome
- C. Renal stones
- D. Acute post-streptococcal glomerulonephritis
Correct Answer: A
Rationale: The correct answer is A because Berger's disease (IgA nephropathy) is a common cause of recurrent haematuria. The other options (b-e) are less common or present differently.
Regarding cafe-au-lait spots:
- A. They can be normal findings
- B. They are found in tuberous sclerosis
- C. When present in a child, > 4 spots each > 0.5 cm, is diagnostic of neurofibromatosis type II
- D. Typical appearance in neurofibromatosis is of a smooth border
Correct Answer: A
Rationale: Cafe-au-lait spots can be a normal variant and do not always indicate an underlying pathology.