Nokea
Which of the actions suggested to the RN by the PN during a planning conference for a 10 month-old infant admitted 2 hours ago with bacterial meningitis would be acceptable to add to the plan of care?
- A. Measure head circumference
- B. Place in airborne isolation
- C. Provide passive range of motion
- D. Provide an over-the-crib protective top
Correct Answer: A
Rationale: Measuring head circumference monitors for complications like hydrocephalus in meningitis.
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An infant is born with a 7 cm × 6 cm lesion over the upper extremity from the elbow to the shoulder. The lesion is indurated and purpuric, with some petechiae around the edges. No other areas of petechiae are noted on the skin. The infant is doing well without other systemic problems. You are called by the pediatric nurse practitioner to the NICU. What is the most appropriate next step?
- A. Do nothing because the infant is doing well and had good Apgars.
- B. Obtain an ultrasound for more information about the lesion.
- C. Obtain an MRI to assess the extent of the lesion.
- D. Obtain labs, including a CBC with platelet count and fibrinogen.
Correct Answer: B
Rationale: Ultrasound is a non-invasive initial diagnostic tool that provides detailed information about vascular lesions and their flow characteristics.
Mario is 2 years old, brought to the Well Child Clinic for his regular visit. On physical exam, he had the following anthropometric measurements: Weight - 15 kgs, Height - 90 cms, Head Circumference - 48 cms. On developmental screening, he was able to do the following: could stand momentarily on one foot, draw a circle and imitate a cross, talk in simple sentences and tell a story. Mother claimed that he is dry by night. The head circumference of Mario is:
- A. Normal
- B. Below normal
- C. Above normal
- D. Variation of normal
Correct Answer: A
Rationale: 48 cm is within the normal range (46-50 cm) for a 2-year-old.
The main element of immunization program is one of the following?
- A. Information, education and communication
- B. Assessment and evaluation of the program
- C. Research studies
- D. Target setting
Correct Answer: A
Rationale: IEC is critical to ensure community participation and vaccine uptake.
A 13-year-old is seen for a routine checkup. What is an expected emotional development milestone for this age?
- A. Developing strong attachments to caregivers.
- B. Experiencing self-conscious emotions and identity exploration.
- C. Demonstrating separation anxiety.
- D. Developing a sense of trust in relationships.
Correct Answer: B
Rationale: Adolescents explore identity and experience heightened self-consciousness, aligning with typical emotional development.
Fever
- A. Cough
- B. Rib tenderness
- C. Shortness of breath
- D. Normal pulse oximetry
Correct Answer: B
Rationale: Fever would decrease suspicion for pulmonary embolism because it suggests an alternative diagnosis such as infection or inflammation rather than a clot-related condition.