Nokea
Which is descriptive of attention deficit hyperactivity disorder (ADHD)?
- A. Manifestations exhibited are so bizarre that the diagnosis is fairly easy.
- B. Manifestations affect every aspect of the child's life but are most obvious in the classroom.
- C. Learning disabilities associated with ADHD eventually disappear when adulthood is reached.
- D. Diagnosis of ADHD requires that all manifestations of the disorder be present.
Correct Answer: B
Rationale: Option B is descriptive of attention deficit hyperactivity disorder (ADHD). Manifestations of ADHD can significantly impact the child's life, but are most noticeable in the classroom setting. Children with ADHD may struggle with paying attention, staying organized, controlling impulsive behavior, and following instructions in the school environment. While symptoms can also affect other areas of life, such as social interactions and familial relationships, they are typically most prominently displayed in the structured school setting, making it easier to recognize and diagnose the disorder.
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A 2-month-old premature infant born at 30 weeks gestation is scheduled for an inguinal hernia repair. Which of the following preoperative findings would BEST predict an increased risk of postoperative apnea?
- A. Hemoglobin 7 gm/dL
- B. Glucose 61 mg/dL
- C. Room air SpO2 92%
- D. N/A
Correct Answer: A
Rationale: Low hemoglobin levels in a premature infant can increase the risk of postoperative apnea due to reduced oxygen-carrying capacity.
Severe and extensive hemolysis causes which of the ff?
- A. Leg ulcers
- B. Shock
- C. Priapism
- D. Compromised growth
Correct Answer: B
Rationale: Severe and extensive hemolysis can lead to the destruction of a large number of red blood cells, causing a significant release of hemoglobin into the bloodstream. This excessive release of hemoglobin can overwhelm the body's ability to clear it, leading to the accumulation of toxic byproducts such as free hemoglobin and heme. These byproducts can lead to various complications, one of which is the potential for causing shock. Shock is a life-threatening condition characterized by inadequate tissue perfusion and oxygen delivery to vital organs due to a systemic vascular response to the circulating toxins and byproducts of hemolysis. It is a severe consequence of extensive hemolysis and requires immediate medical intervention to stabilize the patient.
In children with asthma, which of the following preoperative preparations is LEAST likely to be necessary?
- A. Increase in beta-agonist dosage
- B. Addition of systemic steroids
- C. Bronchodilator therapy
- D. None of the above
Correct Answer: D
Rationale: In stable asthmatic patients, additional interventions like systemic steroids or increased beta-agonist doses are not always necessary unless there are signs of exacerbation.
A client on hemodialysis is complaining of muscle weakness and numbness in his legs. His lab results are: Na 136 mEq/L, K 5.9 mEq/L, Cl 100 mEq/L, ca 8.5 mg/dl. Which electrolyte imbalance is the client suffering from?
- A. Hyperkalemia
- B. Hypocalcemia
- C. Hypernatremia
- D. Hypochloremia
Correct Answer: A
Rationale: The client is experiencing muscle weakness and numbness in his legs, which are symptoms commonly associated with hyperkalemia (high potassium levels). The potassium level of 5.9 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia. Hyperkalemia can lead to muscle weakness, numbness, and potentially more severe complications like cardiac arrhythmias.
The least common late neurologic sequelae that may be encountered post craniospinal irradiation in a 9-year-old child with medulloblastoma is
- A. microcephaly
- B. learning disabilities
- C. cognitive impairment
- D. second malignancy
Correct Answer: D
Rationale: Second malignancy is a rare late effect compared to cognitive and learning impairments.