Nokea
While assessing a newborn infant for developmental hip dysplasia (DDH), the nurse evaluates which of the following signs as indicating the presence of DDH?
- A. One knee is lower when both legs are flexed
- B. Thigh and gluteal skin folds are symmetrical
- C. Hip adduction of affected side is limited
- D. Negative Ortolani sign when hips are abducted
Correct Answer: A
Rationale: In developmental hip dysplasia (DDH), one knee appearing lower than the other when both legs are flexed indicates a possible dislocated hip joint or hip dysplasia. This finding is known as the Galeazzi sign and is often used as a clinical indicator for DDH in newborn infants. It suggests a discrepancy in leg lengths due to hip instability or malformation. Therefore, this sign is important in helping to diagnose DDH and initiating appropriate interventions early on.
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Biopsy is not usually performed for a child with suspicion of Wilms tumor EXCEPT
- A. age of 2-3 year
- B. signs of inflammation or infection
- C. significant lymph node enlargement radiologically
- D. intratumoral calcification radiologically
Correct Answer: D
Rationale: Presence of intratumoral calcifications may warrant biopsy to rule out other diagnoses.
A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, "Wait a minute" and "I'm not ready." The nurse should recognize this as which description?
- A. This is normal behavior for a school-age child.
- B. The behavior is not seen past the preschool years.
- C. The child thinks the nurse is punishing her.
- D. The child has successfully manipulated the nurse in the past.
Correct Answer: A
Rationale: This is normal behavior for a school-age child. School-age children often assert their independence and control in various situations, such as medical procedures. It is common for children in this age group to express hesitation or resistance when faced with something uncomfortable or unfamiliar, like starting an IV line. The child's behavior of saying "Wait a minute" and "I'm not ready" is a typical response for a 10-year-old girl and does not necessarily indicate manipulation, punishment perception, or behavior typical of younger children. In this case, the nurse should acknowledge the child's feelings, provide reassurance, and offer explanations to help her feel more comfortable and in control of the situation.
The MOST common cause of obstructive sleep apnea in children is
- A. obesity
- B. allergies
- C. adenotonsillar hypertrophy
- D. pharyngeal reactive edema due to gastroesophageal reflux
Correct Answer: C
Rationale: Adenotonsillar hypertrophy is the leading cause of obstructive sleep apnea in children.
The BEST statement describing the implication of a 6-month-old boy 'transferring object to hand' is
- A. visuomotor coordination
- B. comparison ability
- C. voluntary release of objects
- D. increasing autonomy
Correct Answer: A
Rationale: Transferring objects between hands indicates developing visuomotor coordination.
Laboratory findings consistent with acute glomerulonephritis include all of the following except :
- A. hematuria.
- B. polyuria.
- C. proteinuria.
- D. white cell casts.
Correct Answer: B
Rationale: Acute glomerulonephritis is a condition characterized by inflammation of the glomeruli in the kidneys, leading to kidney dysfunction. Common laboratory findings consistent with acute glomerulonephritis include hematuria (blood in the urine), proteinuria (protein in the urine), and white cell casts (indicative of inflammation in the kidney tubules). Polyuria, which refers to excessive urination, is not a typical laboratory finding associated with acute glomerulonephritis. Instead, patients with acute glomerulonephritis often present with oliguria or reduced urine output due to impaired kidney function. Therefore, polyuria is not consistent with the typical laboratory findings of acute glomerulonephritis.