Nokea
The most common cause of bacterial meningitis in children under 5 years is:
- A. Neisseria meningitidis
- B. Haemophilus influenzae
- C. Streptococcus pneumoniae
- D. Listeria monocytogenes
Correct Answer: C
Rationale: Streptococcus pneumoniae is the leading cause of bacterial meningitis in children under 5 years, especially in those who are not immunized.
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A hospitalized client with chemotherapy-induced stomatitis complains of mouth pain. What is the best initial nursing action?
- A. Encourage frequent mouth care
- B. Cleanse the tongue and mouth with glycerin swabs
- C. Obtain a soft diet for the client
- D. Administer a topical analgesic per PRN protocol.
Correct Answer: D
Rationale: Administering a topical analgesic provides immediate pain relief, allowing the client to tolerate mouth care and other interventions.
Developmental delay in children below 3 years of age is defined as
- A. 25% departure from typical performance in 2 developmental domains
- B. 25% departure from typical performance in any developmental domain
- C. 30% departure from typical performance in ≥2 developmental domains
- D. 30% departure from typical performance in any developmental domain
Correct Answer: D
Rationale: Developmental delay in children below 3 years is defined as a 30% departure from typical performance in any developmental domain, indicating significant lag.
A 3-year-old child diagnosed with congestive heart failure is receiving maintenance doses of digoxin and furosemide (Lasix). She is rubbing her eyes when she is looking at the lights in the room and her heart rate is 65 beats per minute. The nurse expects which laboratory finding?
- A. Hypokalemia
- B. Hypomagnesemia
- C. Hypocalcemia
- D. Hypophosphatemia
Correct Answer: A
Rationale: Hypokalemia is a common side effect of furosemide, a diuretic, and can exacerbate digoxin toxicity, which may present with symptoms such as visual disturbances and bradycardia.
What FOUR other features may you find on her physical examination if you suspect infective endocarditis?
- A. Intracranial hemorrhage
- B. Conjunctival hemorrhages
- C. Glomerulonephritis
- D. Roth spots
Correct Answer: D
Rationale: These physical signs are common in infective endocarditis and help with clinical diagnosis.
The following are true of vitamin K:
- A. It is a water-soluble vitamin
- B. It is found mainly in red meat
- C. After infancy most is synthesised by the gut flora
- D. Low levels after birth may lead to intracerebral haemorrhage
Correct Answer: C
Rationale: Vitamin K is synthesized by gut flora after infancy. It is a fat-soluble vitamin, and low levels after birth can lead to hemorrhagic disease of the newborn.