Nokea
Which is an important consideration when the nurse is discussing enuresis with the parents of a young child?
- A. Enuresis is more common in girls than in boys.
- B. Enuresis is neither inherited nor has a familial tendency.
- C. Organic causes that may be related to enuresis should be considered first.
- D. Psychogenic factors that cause enuresis persist into adulthood.
Correct Answer: C
Rationale: An important consideration when the nurse is discussing enuresis with the parents of a young child is that organic causes related to enuresis should be considered first. Enuresis, or bedwetting, can have various causes including physical issues like urinary tract infections, constipation, or structural abnormalities. It is essential to rule out any underlying medical conditions before addressing behavioral or psychological factors. By focusing on organic causes first, healthcare providers can ensure that the child receives appropriate evaluation and treatment, leading to better outcomes.
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What is the best method to obtain a urine sample in an 8-month-old being evaluated for a UTI?
- A. Clean the perineum front-to-back and apply a urine collection bag.
- B. Insert an indwelling Foley catheter.
- C. Place a sterile cotton ball in the diaper and collect with a syringe.
- D. Perform an in-and-out (straight) catheterization.
Correct Answer: D
Rationale: For infants who are not toilet-trained, an in-and-out catheterization is the most reliable method for obtaining a sterile urine sample.
A 2-year-old child presents with a peeling, erythematous rash on the hands and feet. The mother reports that he has become ill tempered and refuses to walk about, preferring to lie in bed. Physical examination reveals an irritable, pale child with photophobia. Temperature is 98.5°F, heart rate is 80/minute, and respiratory rate is 23/minute. Tremor of the tongue is evident. Further history and follow-up evaluation reveal that the child's elder brothers have been playing with liquid mercury. Which is the most likely diagnosis?
- A. Measles
- B. Fifth disease
- C. Kawasaki disease
- D. Acrodynia
Correct Answer: D
Rationale: Acrodynia, also known as pink disease, is caused by chronic mercury exposure. The symptoms described, including the rash, irritability, photophobia, and tremor, are consistent with mercury poisoning.
You are meeting with parents of a 10-year-old child who recently develops acute lymphoblastic leukemia (ALL). Which of the following is LEAST likely to increase the risk of CNS relapse in children with ALL?
- A. first traumatic lumbar puncture (LP)
- B. T-cell leukemia
- C. cranial nerve involvement at the time of diagnosis
- D. presence of lymphoblast in the CSF at any time during treatment
Correct Answer: A
Rationale: A first traumatic lumbar puncture is less likely to increase the risk of CNS relapse compared to other factors like T-cell leukemia or cranial nerve involvement.
A 10-month-old child can do all the following EXCEPT
- A. says mama or dada
- B. follows one-step command without gesture
- C. points to objects or real first word
- D. speaks inhibition word 'no'
Correct Answer: D
Rationale: Speaking inhibition words like 'no' typically occurs later.
20-year old Mr. Ang fell off from his horse, and sustained a lft hip fracture. Buck's extension traction is applied. The following statements are true about Buck's extension traction except:
- A. used as a temporary measure in adults to control muscle spasm and pain
- B. applied by orthopedic surgeon under aseptic conditions using wires and pins
- C. The pulling force is transmitted to the musculoskeletal structures
- D. used definitively to treat fractures in children
Correct Answer: D
Rationale: Buck's extension traction is typically used as a temporary measure in adults to control muscle spasm and pain while awaiting definitive treatment, such as surgery. It is applied by an orthopedic surgeon under aseptic conditions using wires and pins, through which the pulling force is transmitted to the musculoskeletal structures of the patient. However, Buck's extension traction is not used definitively to treat fractures in children; other treatment modalities are often preferred for pediatric fractures.