Nokea
You are evaluating a 6-year-old male child with Langerhans cell histiocytosis (LCH); the parents state that the most common site of bone involvement is
- A. skull
- B. vertebra
- C. mandible
- D. pelvis
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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What is the corrected age of a child born at 30 weeks gestation on May 2, 2014, who is being tested on August 5, 2014?
- A. 3 months
- B. 2 weeks
- C. 2.6 months
- D. 4 weeks
Correct Answer: B
Rationale: To calculate the corrected age of a premature child, you need to adjust for the weeks of prematurity. In this case, the child was born at 30 weeks gestation. From May 2, 2014, to August 5, 2014, is a span of 14 weeks. Subtracting the 30 weeks of gestation from the total time passed (14 weeks) gives the corrected age, which is 14 - 30 = -16 weeks. Since negative weeks are not relevant here, the corrected age is 0 weeks, which is equivalent to 2 weeks.
In the morning, a healthcare professional receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the healthcare professional see first?
- A. The child with tachypnea and pulmonary congestion
- B. The child with hepatomegaly and normal respiratory rate
- C. The child with dependent and sacral edema and regular pulse
- D. The child with periorbital edema and normal respiratory rate
Correct Answer: A
Rationale: The child with tachypnea and pulmonary congestion should be seen first as these symptoms indicate a more severe form of fluid-volume excess that requires immediate attention. Tachypnea is an increase in respiratory rate, which could be a sign of respiratory distress, and pulmonary congestion indicates fluid accumulation in the lungs, posing a significant risk to the child's respiratory function.
Which question does not provide information regarding the family's cultural values?
- A. Who makes the decisions?
- B. What is the child's date of birth?
- C. What are the daily routines and rules of mealtime?
- D. What do the parents believe about disability?
Correct Answer: B
Rationale: The correct answer is B. Asking for the child's date of birth is a factual question that does not directly relate to the family's cultural values. The other choices (A, C, D) explore aspects that could provide insights into the family's cultural values and beliefs, such as decision-making dynamics, daily routines, mealtime rules, and views on disability.
A 5-year-old girl requires a craniotomy for subarachnoid hemorrhage following a motor vehicle collision. Which of the following parameters is consistent with a postoperative diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH)?
- A. Serum osmolality 300 mOsm/L
- B. Serum sodium 128 mEq/L
- C. Urine sodium < 20 mmol/L
- D. N/A
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?
- A. I will make sure he gets his measles vaccine as soon as he gets home.
- B. He can stop taking his medication next week.
- C. I should check his urine for protein when he goes to the bathroom.
- D. He should eat a low-protein diet for the next few weeks.
Correct Answer: C
Rationale: In nephrotic syndrome, monitoring urine for protein is essential as it helps track the child's condition. Checking urine for protein should be done as part of the discharge teaching to keep a record of the child's urinary proteins and to monitor the effectiveness of the treatment plan. It is crucial for parents to understand this aspect of care to ensure proper management of the child's condition.