Nokea
The nurse discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching?
- A. My daughter should wash and wipe the perineal area from front to back.'
- B. I am only going to have my daughter wear cotton underwear.'
- C. It is acceptable to take frequent bubble baths.'
- D. She needs to drink lots of fluids and void frequently.'
Correct Answer: C
Rationale: Oils in bubble bath and similar products are known to irritate the urethra.
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Bell's palsy is:
- A. Injury of n. trigeminus
- B. Central paralysis of the facial nerve
- C. Peripheral paralysis of the facial nerve
- D. All are true
Correct Answer: C
Rationale: Bell's palsy is a peripheral facial nerve paralysis.
Following acute bronchiolitis, which virus is associated with the long-term complication of bronchiolitis obliterans?
- A. Adenovirus
- B. Human metapneumovirus
- C. Influenza virus
- D. Parainfluenza virus
Correct Answer: A
Rationale: Adenovirus is the virus most commonly linked to bronchiolitis obliterans, a rare but serious long-term complication involving irreversible airway obstruction post-bronchiolitis.
A 3-month-old female presents to the emergency room with vomiting and abdominal distension. She has a left-side abdominal mass, and an abdominal ultrasound confirms an 8-cm mass arising from the left kidney. Liver lesions are also noted. Nephrectomy is performed and reveals a histologic diagnosis of malignant rhabdoid tumor of the kidney(MRTK). Which of the following is not a true statement about the management of this patient?
- A. Most patients with rhabdoid tumor of the kidney present in infancy.
- B. Most patients with rhabdoid tumor of the kidney present with metastatic(stage III or IV) disease.
- C. She has an excellent prognosis with surgery, chemotherapy, and radiation.
- D. Germline testing for SMARCB1/INI1 mutation on chromosome 22 is recommended, with brain MRI every 3 months until she is 5 years old, if testing is germline positive for SMARCB1/INI1.
Correct Answer: C
Rationale: Malignant rhabdoid tumors have a poor prognosis despite aggressive treatment.
When assessing a child with aspirin overdose, which of the following will be expected?
- A. Metabolic alkalosis
- B. Respiratory alkalosis
- C. Metabolic acidosis
- D. Respiratory acidosis
Correct Answer: C
Rationale: Aspirin overdose typically causes metabolic acidosis due to salicylate accumulation.
A 15-year-old girl with a history of hundreds of colon polyps and appendectomy presents with an abdominal mass. Histology shows a uniformly cellular tumor comprised of cytologically bland fibroblasts which merge with the background collagen. Staining for beta-catenin shows nuclear positivity. What other tumor might this patient be at risk for?
- A. Jaw osteoma
- B. Benign colorectal polyps with prominent smooth muscle
- C. Endometrial carcinoma
- D. Cerebellar medulloblastoma
Correct Answer: A
Rationale: Patients with Gardner's syndrome are at risk for jaw osteomas among other tumors.