These facts are true regarding the developmental stage of preschool children EXCEPT
- A. handedness is achieved by 3 years of age
- B. boys are usually later than girls in achieving bladder control
- C. knowing gender by 4 years
- D. egocentric thinking
Correct Answer: D
Rationale: Egocentric thinking is characteristic of preschool-age children.
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The nurse is examining 12-month-old Amy, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. What is most likely the cause of the diaper rash?
- A. Impetigo
- B. Candida albicans
- C. Urine and feces
- D. Infrequent diapering
Correct Answer: B
Rationale: The presentation of perianal inflammation with satellite lesions that cross the inguinal folds is highly suggestive of a Candida albicans (yeast) diaper rash. Yeast diaper rash is characterized by redness, swollenness, and usually involves the skin folds. The warm, moist environment created by a diaper provides an ideal setting for Candida albicans to grow and cause a rash. The presence of satellite lesions that cross the inguinal folds further supports the diagnosis of a yeast infection rather than other causes like impetigo, irritation from urine and feces, or infrequent diapering. Treatment for yeast diaper rash typically involves antifungal creams or ointments.
You are discussing with medical students the role of chemotherapy in malignant germ cell tumors (GCTs); you state that GCTs are sensitive to some types of chemotherapy. Of the following, the MOST effective chemotherapeutic agent in GCTs is
- A. vincristine
- B. cyclophosphamide
- C. cisplatin
- D. methotrexate
Correct Answer: C
Rationale: Cisplatin is a cornerstone in the treatment of germ cell tumors.
A client asks nurse Carlos the rationale for giving multi-drug treatment for tuberculosis. Which is an appropriate response?
- A. multiple drugs allow reduced levels of drugs to be given
- B. multiple drugs reduce undesirable drug side-effect
- C. multiple drugs potentiate the action fo the drugs
- D. multiple drugs reduce development of resistant strains of the bacteria
Correct Answer: D
Rationale: Giving multiple drugs for the treatment of tuberculosis is essential because it helps reduce the development of resistant strains of the bacteria. Tuberculosis is caused by Mycobacterium tuberculosis, which has the potential to develop resistance to single drug therapy through genetic mutations. The use of multiple drugs in combination therapy prevents the bacteria from developing resistance since they work through different mechanisms of action, making it harder for the bacteria to adapt and survive. This approach is known as Directly Observed Treatment, Short-course (DOTS), and it is an effective strategy recommended by the World Health Organization to combat the rising issue of drug-resistant tuberculosis.
Mr Santos is placed on seizure precaution. Which of the following would be contraindicated?
- A. Obtain his oral temperature g. Allow him to wear his own clothing f. Encourage to perform his own personal h. Encourage him to be out of bed hygiene
Correct Answer: A
Rationale: When a patient is placed on seizure precautions, obtaining oral temperature would be contraindicated. This is because sticking a thermometer in the mouth may pose a risk during a seizure episode, as the patient might bite down on it and cause injury. It is important to prioritize safety measures to minimize the risk of harm to the patient. Other methods of monitoring temperature, such as using a tympanic thermometer or a forehead thermometer, would be more appropriate in this situation.
Which finding requires immediate attention in a child with glomerulonephritis?
- A. Sleeping most of the day with BP 170/90.
- B. Urine output of 190 mL in 8 hours with Coca-Cola-colored urine.
- C. Severe headache and photophobia.
- D. Refusal to eat with poor appetite.
Correct Answer: C
Rationale: A severe headache with photophobia may indicate hypertensive encephalopathy; this requires prompt evaluation.