Burns Pediatric Primary Care Test Bank

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Which vitamin is recommended for all women of childbearing age to reduce the risk of neural tube defects such as spina bifida?

  • A. A
  • B. C
  • C. Niacin
  • D. Folic acid
Correct Answer: D

Rationale: Folic acid is the correct answer. All women of childbearing age are recommended to take folic acid to reduce the risk of neural tube defects such as spina bifida in their offspring. Neural tube defects occur in the early stages of pregnancy, often before a woman even knows she is pregnant, which is why it is important for all women of childbearing age to ensure they have adequate folic acid intake. Folic acid is a B vitamin that helps the body make new cells and plays a crucial role in the development of the baby's neural tube, which eventually becomes the brain and spinal cord. Adequate folic acid intake before and during pregnancy can significantly reduce the risk of neural tube defects. That's why it is recommended for all women of childbearing age to take a daily folic acid supplement or consume foods fortified with folic acid.

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If a patient has elevated pulmonary vascular pressures, the nurse understands that the patient is most likely to develop which of the ff. physiological cardiac changes?

  • A. Left atrial atrophy
  • B. Left ventricular hypertrophy
  • C. Right atrial atrophy
  • D. Right ventricular hypertrophy
Correct Answer: D

Rationale: Elevated pulmonary vascular pressures can lead to pulmonary hypertension, which causes increased pressure in the right side of the heart. The right ventricle has to work harder to pump blood against the increased resistance in the pulmonary circulation. Over time, this can result in the development of right ventricular hypertrophy as the muscle of the right ventricle thickens in response to the increased workload. This is a compensatory mechanism to try to maintain cardiac output despite the increased pressure in the pulmonary circulation. Left atrial atrophy, left ventricular hypertrophy, and right atrial atrophy are not typically associated with elevated pulmonary vascular pressures.

The MOST appropriate advice for a 4-year-old child visiting the outpatient department with excessive crying is

  • A. reassures her that this is a normal phenomenon
  • B. seek more history regarding other skills and developmental domains
  • C. refer her to pediatric psychiatry
  • D. investigate for child abuse
Correct Answer: B

Rationale: Further history may help differentiate normal behavior from developmental concerns.

For a patient with gastroesophageal reflux symptoms, the purpose of esophageal pH monitoring is to evaluate for:

  • A. esophagitis from the reflux.
  • B. frequency of the reflux.
  • C. gastric emptying delays.
  • D. possible obstructions.
Correct Answer: B

Rationale: Esophageal pH monitoring measures the frequency and duration of acid exposure in the esophagus, helping diagnose GERD.

Hyperparathyroidism is caused by increased levels of thyroxine in blood plasma. A client with this endocrine dysfunction would experience:

  • A. Heat intolerance and systolic
  • B. Diastolic hypertension and widened hypertension pulse pressure
  • C. Weight gain and heat intolerance
  • D. Anorexia and hyper-excitability
Correct Answer: A

Rationale: Hyperparathyroidism is caused by increased levels of parathyroid hormone (PTH), not thyroxine. The effects of hyperparathyroidism include increased calcium levels in the blood, which can lead to symptoms such as heat intolerance and systolic hypertension. Systolic hypertension is when the top number in a blood pressure reading is elevated. This is why option A (heat intolerance and systolic hypertension) is the correct choice for a client with hyperparathyroidism. Options B, C, and D do not accurately reflect the symptoms associated with this endocrine dysfunction.

Which is most likely to encourage parents to talk about their feelings related to their child's illness?

  • A. Be sympathetic.
  • B. Use direct questions.
  • C. Use open-ended questions.
  • D. Avoid periods of silence.
Correct Answer: C

Rationale: Using open-ended questions encourages parents to freely express their feelings and thoughts without feeling constrained by yes or no answers. Open-ended questions allow for a more open and extensive conversation, encouraging parents to share their emotions and concerns more effectively. This approach can help parents feel understood and supported, ultimately fostering more honest and meaningful discussions about their child's illness.

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