Nokea
You are examining a 12-year-old female adolescent with a small nevus in the thigh; the mother is concerned regarding the future development of melanoma. All the following findings raise suspicion of melanoma EXCEPT
- A. enlarging nevus
- B. changing colors
- C. irregular margins
- D. easily bleeds
Correct Answer: E
Rationale: Spitz nevus is a benign mimic of melanoma and does not raise suspicion.
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Which is an accurate description of a Kasai procedure?
- A. A palliative procedure in which the bile duct is attached to a loop of bowel to assist with bile drainage.
- B. A curative procedure that connects the bile duct to the bowel.
- C. A curative procedure where the bile duct is banded.
- D. A palliative procedure where the bile duct is banded.
Correct Answer: A
Rationale: The Kasai procedure is a palliative surgery for biliary atresia that helps restore bile flow and delays the need for liver transplantation.
In neuroblastoma, metastatic spread can occur via local invasion or distant hematogenous/lymphatic routes. The LEAST common site of metastases in neuroblastoma is
- A. long bone
- B. bone marrow
- C. lung
- D. skin
Correct Answer: D
Rationale: Skin metastases are rare in neuroblastoma compared to bone, bone marrow, and lung involvement.
An infant with tetralogy of Fallot becomes cyanotic and dyspneic after a crying episode. To relieve the cyanosis and dyspnea, the nurse should place the infant in the:
- A. Orthopneic position
- B. Knee-chest position
- C. Lateral Sims' position
- D. Semi-Fowler's position
Correct Answer: A
Rationale: The orthopneic position is the best position to relieve cyanosis and dyspnea in an infant with tetralogy of Fallot. This position involves sitting up and leaning forward, which helps improve lung expansion and oxygenation. Placing the infant in the orthopneic position will reduce the workload on the heart, improve oxygenation, and relieve symptoms of cyanosis and dyspnea associated with tetralogy of Fallot. It allows for better expansion of the lungs and improves ventilation-perfusion matching, thereby enhancing oxygen exchange and alleviating the cyanotic spell.
A 27-year old adult is admitted for treatment of Crohn's disease. Which information is most significant when the nurse assesses nutritional health?
- A. Anthropometric measurements
- B. dry skin
- C. bleeding gums
- D. facialrubor
Correct Answer: A
Rationale: Anthropometric measurements, such as height, weight, body mass index (BMI), and waist circumference, are essential in assessing the nutritional health of a patient with Crohn's disease. These measurements provide objective data about the patient's nutritional status, body composition, and risk for malnutrition. Monitoring changes in these measurements over time can help identify nutritional deficiencies, weight loss, or malnutrition in patients with Crohn's disease. Dry skin, bleeding gums, and facial rubor can be symptoms of other health conditions, but anthropometric measurements directly assess the nutritional health of the patient.
The nurse is taking a health history on an adolescent. Which best describes how the chief complaint should be determined?
- A. Ask for detailed listing of symptoms.
- B. Ask adolescent, "Why did you come here today?"
- C. Use what adolescent says to determine, in correct medical terminology, what the problem is.
- D. Interview parent away from adolescent to determine chief complaint.
Correct Answer: B
Rationale: When determining the chief complaint for an adolescent during a health history, the best approach is to directly ask the adolescent, "Why did you come here today?" This allows the nurse to understand the reason for the visit from the adolescent's perspective and helps in identifying the primary concern or reason for seeking medical care. Adolescent patients should be encouraged to express their own concerns and symptoms in their own words, which can help in building trust and promoting open communication between the nurse and the patient. It is important to prioritize the adolescent's input in determining the chief complaint, as it relates to their own health and well-being.