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Example Questions
Example Question #101 : Conditions And Treatments
While doing a standard ophthalmoscopic exam on a seven year old female, the examiner notices that while the light reflex of the left eye is red, the light reflex of the right eye appears bright yellow. The right pupil is also less reactive to light, and the right eye appears to be slightly bulging. The examiner should be suspicious of which of the following conditions?
Pinguecula
Retinoblastoma
Cataract
Hordeolum
Retinoblastoma
Retinoblastoma is the most common form of ocular cancer in children. It is derived from developing retinal cells. The most common symptoms are a white or yellow light reflex (also known as leukocoria), diminished pupillary reflex, crossing of the eyes, impaired vision, and bulging of the affected eye. A cataract may also cause the pupil to appear white or to produce a white or yellow light reflex, but it will not cause bulging of the eye.
A pinguecula is a fatty deposit on the sclera which will not alter the red-light reflex, and a hordeolum is outside the eye itself: it is an infection of a hair follicle of the eyelid, also known as a stye.
Example Question #102 : Conditions And Treatments
A labor and delivery nurse is speaking to a new mother about her premature infant, and is explaining why the infant will have difficulty with heat regulation.
Which of the following statements made by the nurse best explains why a perterm infant cannot conserve heat properly?
"The preterm infant lacks white fat, which provides the infant with a heat source due to underdeveloped musculature and the inability to utilize the process of shivering to produce heat."
"The preterm infant has a lack of subcutaneous fat, and a large surface area to body weight ratio, as well as a lack of brown fat that provides heat to infants due to its unique thermogenic properties."
"The preterm infant cannot generate heat effectively because of a lack of surfactant in the skin and therefore cannot generate or preserve a proper body temperature."
"The preterm infant has an immature hypothalamus, which cannot set the infant's internal temperature properly leading to large amounts of heat being lost via convection."
"The preterm infant has too little protein reserves around the kidneys, the neck, between the scapulae, and behind the sternum, and therefore cannot generate heat and can lead to hypothermia."
"The preterm infant has a lack of subcutaneous fat, and a large surface area to body weight ratio, as well as a lack of brown fat that provides heat to infants due to its unique thermogenic properties."
A preterm infant cannot conserve heat due to several reasons. The infant has a lack of subcutaneous fat, has a large surface area relative to their body weight, a lack of glucose reserves, and a lack of brown fat - which is a unique type of fat that is capable of generating a greater amount of heat than just ordinary fat.
Example Question #25 : Pediatric Conditions
What specific enzyme deficiency accounts for 95% of all cases of congenital adrenal hyperplasia?
7-alpha-hydroxylase deficiency
Beta-glucuronidase deficiency
Estrogen synthetase deficiency
21-hydroxylase deficiency
21-hydroxylase deficiency
In 21-hydroxylase deficiency, cortisol production is reduced, which in turn causes adrenocorticotropic hormone (ACTH) to increase. The precursors for the cortisol are then shunted into androgen production since these are steroids, and are thus derived from cholesterol.
Example Question #102 : Conditions And Treatments
The community health nurse knows that teaching has been effective when the father of a newborn states __________.
"I will place bumper pads in the crib to prevent injury."
"I will place my child on his/her back and in a crib with stuffed animals to create familiarity."
"My child will sleep in the bed with me until the first month of life."
"I will place my child on his/her back to sleep."
"I will place my child on his/her side to sleep, supported by pillows."
"I will place my child on his/her back to sleep."
Newborns should be placed on their back, in their crib, with nothing else when put to sleep. The crib may contain a fitted sheet or a light blanket. Crib pads, pillows, and stuffed animals are not advised because they may interfere with the child's ability to breathe.
Example Question #103 : Conditions And Treatments
The postpartum nurse is caring for a family and their new baby, a two day old infant. The baby is "spitting up" following every formula feeding. The nurse may suggest __________.
using a "soft" instead of a "standard" bottle nipple
giving only 15-30 milliliters per feeding
laying the baby on it's back after feedings
increasing the frequency of feedings
switching brands of formula
giving only 15-30 milliliters per feeding
Typically, the digestive system of a 2-day-old infant can only accommodate 15-30 milliliters of formula comfortably. The infant's stomach will grow considerably over the coming weeks. Frequent spitting up could be due to overfeeding. Before switching formula brands, try decreasing the amount fed at each feeding. Increasing the frequency of feedings may add to this problem. Another possibility, that the infant is feeding too fast, may be corrected by using a "slow-flow" instead of a "soft" or "standard" nipple. "Soft" nipples may be helpful in infants with poor suck or latch. While feeding and directly afterwards, it is advised to keep the infant in a semi-upright position.
Example Question #104 : Conditions And Treatments
Hippotherapy has the ability to positively impact children who are cognitively, socially, emotionally, or physically challenged. Which of the following therapies is most closely related to hippotherapy?
Art therapy
Music therapy
Massage therapy
Herbal therapy
Pet therapy
Pet therapy
Hippotherapy is therapeutic horseback riding for the handicapped. The motion of the horse can help the child develop flexibility and balance. Working with others and animals can help the child cross social and emotional boundaries. A therapy involving animals (pet therapy) is most similar to hippotherapy.
Example Question #31 : Pediatric Conditions
Jennifer is a 14-year-old patient who has been diagnosed with diphtheria and subsequently, myocarditis. The nurse implements all of the following except __________.
practicing airborne precautions
enforcing bed rest
administering antibiotics
practicing standard precautions
administering antitoxin
practicing airborne precautions
Diphtheria is an illness caused by bacteria (Corynebacterium diphtheriae). It is spread through droplets, requiring droplet precautions. Standard precautions should also be used, as with any patient. Delivery of antitoxin and antibiotics are important to a patient's recovery. Enforcing bedrest is important after a patient has developed myocarditis (inflammation of the heart).
Example Question #32 : Pediatric Conditions
A community health nurse is giving a presentation on pertussis (whooping cough). He tells his audience that which population is most at risk?
Children under 4 years of age
Children from 4-12
Older adults above 85
Older adults from 65-75
Older adults from 75-85
Children under 4 years of age
Children under 4 years of age hold the greatest risk of contracting Pertussis and developing serious complications, including death. Pertussis vaccines are recommended for all age groups. Children can start a vaccination series as early as 2 months of age. New parents are encouraged to become vaccinated before their baby arrives to prevent transmission before the infant is eligible for immunization.
Example Question #105 : Conditions And Treatments
A room designed to accommodate a child with the measles should include which of the following?
Low microscopy pressure device
Positive air pressure
High microscopy pressure device
No air pressure device is necessary
Negative air pressure
Negative air pressure
Measles is an airborne illness. For that reason, air pressure devices are necessary to prevent the spread of infection. Negative air pressure devices will adequately contain the measles virus because air will flow in to the room as opposed to out. Conversely, positive air pressure devices may be used to create an air flow out of a room in severely immunocompromised patients.
Example Question #106 : Conditions And Treatments
The school nurse is approached by a 9-year-old boy who is complaining of severe scalp pruritus. Upon closer examination, the nurse concludes that he has a case of head lice (Pediculosis capitis). She knows all of the following to be true except __________.
his personal grooming items should be soaked in hot water or shampoo
sealing his backpack in a plastic bag for 10 days should kill the lice
treating the clothing of the child may be necessary
head lice may be a sign of poor hygiene
his 5-year-old sister should be examined
head lice may be a sign of poor hygiene
Children and adults with exceptional personal hygiene are equally affected by head lice. The same applies to people of all socioeconomic groups, genders, and nationalities. All of the other options are true nursing interventions for head lice.