Nokea
Which of the following is a form of child abuse that is known to cause intellectual disability?
- A. Shaken baby syndrome
- B. Abused child syndrome
- C. Battered baby syndrome
- D. Damaged infant syndrome
Correct Answer: A
Rationale: Shaken Baby Syndrome: A form of child abuse causing intellectual disability through traumatic brain injury from violent shaking.
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A child, age 9, is being evaluated in the Emergency Department at the hospital. Her mother reports that the child fell down the stairs in her home. Her mother is with her and describes her as a 'clumsy kid.' The nurse practitioner suspects child abuse. Which of these findings indicates that physical abuse may be a chronic problem for the child?
- A. Bloody nose and blackened eyes
- B. Unhealed fractures revealed on x-ray
- C. Clinging to her mother as she attempted to leave
- D. Struggling with the staff that attempts to obtain a blood specimen
Correct Answer: B
Rationale: The correct answer is B - Unhealed fractures revealed on x-ray. This finding indicates chronic physical abuse as unhealed fractures suggest repeated trauma over time. This is concerning because chronic abuse can lead to severe physical and emotional consequences for the child.
A: Bloody nose and blackened eyes may indicate acute physical abuse, but not necessarily chronic abuse.
C: Clinging to her mother as she attempted to leave is a behavior often seen in children who are anxious or scared in a medical setting, but it does not specifically indicate chronic physical abuse.
D: Struggling with the staff that attempts to obtain a blood specimen could be a response to fear or discomfort with medical procedures, which does not definitively point to chronic abuse.
Police bring a patient to the mental health unit. The patient was directing traffic and shouting rhymes on a busy city street. The patient's spouse reports that the patient has not slept or eaten for 3 days. Which assessment findings have priority concern for this patient's plan of care?
- A. Pressured speech and grandiosity
- B. Hyperactivity; not eating and sleeping
- C. Poor concentration and decision making
- D. Insulting
Correct Answer: B
Rationale: The correct answer is B. Hyperactivity, not eating, and not sleeping are priority concerns as they indicate potential mania or hypomania, which can be dangerous and require immediate intervention. Not eating and sleeping for days can lead to physical and mental health complications. Pressured speech and grandiosity (Choice A) are symptoms of mania but not as urgent as lack of eating and sleeping. Poor concentration and decision making (Choice C) are also symptoms of mania, but not as immediately concerning as the lack of eating and sleeping. Insulting behavior (Choice D) is not a priority concern for immediate intervention in this scenario.
Which of the following is a common complication of anorexia nervosa?
- A. Hypertension and hyperglycemia.
- B. Cardiovascular instability and electrolyte imbalances.
- C. Insulin resistance and excessive weight gain.
- D. Severe dehydration and frequent urination.
Correct Answer: B
Rationale: The correct answer is B: Cardiovascular instability and electrolyte imbalances. Anorexia nervosa can lead to severe malnutrition, causing cardiovascular issues like low heart rate and blood pressure. Electrolyte imbalances occur due to inadequate nutrient intake. Hypertension and hyperglycemia (choice A) are not common in anorexia. Insulin resistance and weight gain (choice C) are more associated with conditions like obesity. Severe dehydration and frequent urination (choice D) are not typical manifestations of anorexia.
An individual brought by ambulance to the emergency room is accompanied by a roommate. The patient fights against the restraints and shouts incoherently. The roommate reports that the patient was weak and confused on awakening this morning and about 3 hours ago began "rambling and talking crazy."Â A nurse notes that the patient's skin is flushed and dry. The priority nursing action is to:
- A. take the patient's vital signs.
- B. start intravenous fluids.
- C. administer a sedative.
- D. perform a mental status examination.
Correct Answer: A
Rationale: The correct answer is A: take the patient's vital signs. This is the priority action because the patient is exhibiting signs of potential medical emergency, such as altered mental status, flushed and dry skin, and confusion. Vital signs can provide crucial information about the patient's condition and help determine the urgency of the situation. Starting intravenous fluids (B) may be necessary but should be based on the assessment of vital signs first. Administering a sedative (C) is not appropriate without knowing the underlying cause of the symptoms. Performing a mental status examination (D) is important but not the priority in this situation where the patient's physical condition needs immediate attention.
In Singapore, children and youth with disability in school age:
- A. Are rare at prevalence of less than 1%
- B. Receive services that are governed and funded by MSF only
- C. Are at higher risk of developing mental health conditions than typical children
- D. Need to have confirmed diagnosis before they can receive support in schools
Correct Answer: C
Rationale: School-age children with disabilities are at higher risk for mental health conditions due to social and functional challenges.