Nokea
The nurse is preparing to admit a 5-year-old child with hepatitis A. What clinical features of hepatitis A should the nurse recognize?
- A. The onset is rapid.
- B. Fever occurs early.
- C. All are applicable
- D. Nausea and vomiting are common.
Correct Answer: C
Rationale: The correct answer is C. Hepatitis A typically presents with a rapid onset, early fever, and nausea/vomiting. These are common clinical features seen in patients with hepatitis A. A pruritic rash is not commonly associated with hepatitis A, so choice C is incorrect. Choice A and B alone are not sufficient to cover all the clinical features of hepatitis A.
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Which of the following conditions is characterized by a 'machine-like' murmur in children?
- A. Patent ductus arteriosus
- B. Ventricular septal defect
- C. Atrial septal defect
- D. Coarctation of the aorta
Correct Answer: A
Rationale: The correct answer is A, Patent ductus arteriosus. This condition is characterized by a continuous 'machine-like' murmur due to abnormal blood flow between the aorta and pulmonary artery. Ventricular septal defect (choice B) is characterized by a harsh holosystolic murmur, atrial septal defect (choice C) typically presents with a fixed split S2 and a pulmonary flow murmur, and coarctation of the aorta (choice D) is associated with a systolic murmur in the back and bilateral lower extremities.
A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?
- A. Careful bathing and handling
- B. Monitoring of behavioral status
- C. Maintenance of strict isolation
- D. Administration of packed red blood cells
Correct Answer: A
Rationale: The correct answer is A: Careful bathing and handling. Preoperative care for a child with a Wilms tumor should focus on preventing any trauma to the abdomen, which could lead to tumor rupture. Monitoring behavioral status and maintaining strict isolation are not as critical in this situation. Behavioral status is important but not a priority in preoperative care for a Wilms tumor. Strict isolation is not necessary unless there are specific infectious concerns, which is not typically the case for a Wilms tumor. Administration of packed red blood cells is not a standard preoperative intervention for Wilms tumor.
In pediatric patients, what is the primary concern with untreated vesicoureteral reflux (VUR)?
- A. Recurrent UTIs
- B. Chronic renal failure
- C. Hypertension
- D. Bladder dysfunction
Correct Answer: B
Rationale: The primary concern with untreated vesicoureteral reflux (VUR) in pediatric patients is chronic renal failure. Untreated VUR can lead to this complication due to recurrent urinary tract infections and kidney damage. While recurrent UTIs (Choice A) are a common consequence of VUR, the ultimate worry is the development of chronic renal failure. Hypertension (Choice C) may occur as a result of renal damage but is not the primary concern. Bladder dysfunction (Choice D) is not the most significant consequence of untreated VUR in terms of long-term outcomes compared to chronic renal failure.
What is typically the first sign of puberty in females?
- A. Breast development
- B. Menarche
- C. Pubic hair growth
- D. Axillary hair growth
Correct Answer: A
Rationale: The correct answer is A: Breast development (thelarche) is usually the first sign of puberty in females, typically beginning between ages 8 and 13. This marks the start of puberty, followed by pubic hair growth, a growth spurt, and eventually menarche (the onset of menstruation). Pubic hair growth and axillary hair growth usually follow breast development in the sequence of pubertal changes. Therefore, the first noticeable change indicating the onset of puberty in females is the development of breast buds.
What is the most common symptom of gastroesophageal reflux in infants?
- A. Projectile vomiting
- B. Bilious vomiting
- C. Frequent spitting up
- D. Diarrhea
Correct Answer: C
Rationale: Frequent spitting up is indeed a common symptom of gastroesophageal reflux in infants. It is caused by the backward flow of stomach contents into the esophagus, leading to infants regurgitating milk or formula shortly after feeding. Projectile vomiting (choice A) is more commonly associated with conditions like pyloric stenosis rather than gastroesophageal reflux. Bilious vomiting (choice B) often indicates an obstruction in the gastrointestinal tract. Diarrhea (choice D) is not typically a primary symptom of gastroesophageal reflux in infants.