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The MOST likely cause of a 4-year-old boy refusing to go to bed and remaining active is
- A. thyrotoxicosis
- B. ADHD
- C. behavioral insomnia of childhood
- D. sleep-onset association disorder
Correct Answer: C
Rationale: Behavioral insomnia involves resistance to bedtime routines.
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A 2-year-old male child has an asymptomatic right flank mass discovered incidentally by the mother while bathing. Suspicion of Wilms tumor is raised. Of the following, the LEAST likely investigation to be performed in this child is
- A. plain abdominal radiography
- B. computerized tomography (CT) scan of the abdomen
- C. CT scan of the chest
- D. biopsy of the mass
Correct Answer: D
Rationale: Biopsy is generally avoided in suspected Wilms tumor to prevent upstaging the disease.
A client has squamous cell cancer of the right lung that has metastasized to the brain. In addition to chemotherapy for lung cancer, the physician prescribes lomustine (CeeNU), 100 mg/m2 as a single dose, to treat the brain metastasis. What are the major administration and excretion routes of lomustine?
- A. Oral administration and urinary
- B. I.V. administration and urinary excretion
- C. I.V administration and fecal excretion
- D. Oral administration and fecal excretion
Correct Answer: B
Rationale: Lomustine (CeeNU) is typically administered intravenously (I.V.), making choice B the correct administration route. Lomustine is metabolized in the liver and excreted primarily through the kidneys via urine, which accounts for its urinary excretion. Therefore, the major administration route for lomustine is intravenous (I.V.) and the major excretion route is urinary.
The nurse is caring for a patient on warfarin with an elevated INR level. Which of the ff. would be ordered as the antidote for warfarin?
- A. Vitamin K c.Calcium Chloride
- B. Vitamin B12
- C. Protamine Sulfate
Correct Answer: A
Rationale: Warfarin is an anticoagulant medication that works by inhibiting the production of certain clotting factors in the liver, thus prolonging the time it takes for blood to clot. An elevated INR level indicates that the blood is taking longer to clot than desired, potentially putting the patient at risk for bleeding. Vitamin K is the antidote for warfarin because it helps the liver produce these clotting factors, ultimately reversing the effects of warfarin and promoting normal blood clotting. Administering Vitamin K helps lower the INR level and reduce the risk of bleeding in patients on warfarin therapy. Therefore, in this scenario, Vitamin K would be the appropriate antidote to use for the patient with an elevated INR level.
The nurse encourages a client with an immunologic disorder to eat a nutritionally balanced diet to promote optimal immunologic function. Autoimmunity has been linked to excessive ingestion of:
- A. Protein
- B. Vitamin A
- C. Fat
- D. Zinc
Correct Answer: C
Rationale: Excessive ingestion of fat has been linked to autoimmunity. A diet high in saturated and trans fats can lead to chronic inflammation and disrupt the balance of immune cells, potentially triggering autoimmune responses in the body. Conversely, a nutritionally balanced diet that includes healthy fats like omega-3 fatty acids from sources such as fish, nuts, and seeds can help support optimal immunologic function and reduce the risk of autoimmune disorders.
A parent of a child with glomerulonephritis asks why the urine is discolored. Which is the best response?
- A. It is not uncommon when children take steroids and BP medications.
- B. There is blood in your child's urine, which causes it to be tea-colored.
- C. The urine is concentrated.
- D. A ketogenic diet can cause tea-colored urine.
Correct Answer: B
Rationale: Hematuria (blood in the urine) is a common finding in glomerulonephritis and causes a tea-colored appearance.