A 4-year old boy needs to use a metered-dose inhaler to treat asthma. He cannot coordinate his breathing to use it effectively. What should the nurse suggest that he uses?
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Question 2 of 85
Vitamin K deficiency occur in all except-
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Question 3 of 85
The usual course of pertussis in an infant is characterized by:
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Question 4 of 85
A 3-year-old boy with 'coca cola' colored urine and periorbital edema 3 weeks after scarlet fever most likely has:
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Question 5 of 85
What is the most important next step in management for a 10-year-old boy with severe aplastic anemia, family history of IBMFS, and negative Fanconi anemia testing on peripheral blood?
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Question 6 of 85
A 17-year-old woman presents with a right adnexal mass, elevated lactate dehydrogenase, and mildly elevated beta-HCG. Histology of the tumor reveals a diffuse arrangement of homogeneous tumor cells with faintly eosinophilic cytoplasm, prominent nucleoli, and well-demarcated cell membranes. Scattered syncytiotrophoblasts are appreciated. The background stroma is fibrous and a dense lymphocytic infiltrate peppers the tumor. The diagnosis is:
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Question 7 of 85
During infancy, children's kidneys are characterized by:
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Question 8 of 85
What is it important to assess in a child receiving prednisone to treat nephrotic syndrome?
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Question 9 of 85
A mother brings her 3-week old infant to the clinic because the baby vomits after eating and always seems hungry. Further assessment indicates that the infant's vomiting is projectile, and the child seems listless. Which additional assessment finding indicates the possibility of a life-threatening complication?
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Question 10 of 85
A 3-week old with essentially normal birth history had episodes of intermittent vomiting after feeding. If pyloric stenosis is being considered, you expect the following EXCEPT:
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Question 11 of 85
What is the therapy plan for an 11-month-old boy diagnosed with cystic fibrosis?
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Question 12 of 85
A 14-year-old Syrian male with beta thalassemia major has relocated to your community as a refugee. He has been receiving chronic transfusion therapy in Turkey for the past 3 years. On his first visit, you notice that his height is below the fifth percentile. He has skin discoloration and hepatosplenomegaly. His mother reports they have not had regular access to chelation therapy. Laboratory testing shows a serum ferritin of 6,200 ng/mL. A cardiac MRI shows grossly normal cardiac function but a T2* value of 9 ms. What is the most likely cause of his short stature?
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Question 13 of 85
A 5-month-old boy presents with fevers, poor feeds and worsening breathlessness. He has failure to thrive with head sparing. His saturation is 92% in air and normalises in oxygen. He is tachycardic and tachypnoeic. He has widespread crepitations and a harsh systolic murmur at the left sternal edge. Polymerase chain reaction (PCR) from a nasal swab is positive for respiratory syncytial virus (RSV). His chest x-ray is shown. What is the most likely diagnosis?
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Question 14 of 85
While assessing a child with pyloric stenosis, the nurse is likely to note which of the following?
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Question 15 of 85
The parents of a child with rheumatic fever express concern that their other children will develop the disease. Which of the following would be the nurse's best response?
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Question 16 of 85
Another concern in the care of toddlers is toilet-training. Which of the following is the most important factor for a successful toilet-training?
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Question 17 of 85
How do you classify a 48-month-old child with sore throat, red throat, and enlarged tender lymph nodes?
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Question 18 of 85
Which of the following would the nurse include when developing the plan of care for a neonate prior to surgical repair of a myelomeningocele?
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Question 19 of 85
Which anemia is hypochromic and microcytic?
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Question 20 of 85
Which symptom is typical for Rolandic epilepsy?
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Question 21 of 85
The parents of a 9-year-old ask the nurse what type of play is appropriate. What should the nurse recommend?
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Question 22 of 85
A 19-year-old freshman in college presents with 'lumps' on the right side of his neck and in the right axilla. He had a fever to 39°C 1 day in the past week. On physical exam, there are firm anterior cervical and axillary nodes, all greater than 2 cm in diameter. A chest x-ray shows a large mediastinal mass. A biopsy of the axillary node reveals classic Hodgkin lymphoma. Which of the following symptoms revealed during the history is a B symptom?
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Question 23 of 85
Potential complications of chronic, recurrent pancreatitis includes chronic pain syndrome. Patients presenting with chronic, recurrent pancreatitis and chronic pain need to be particularly screened for:
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Question 24 of 85
Hypergonadotropic hypogonadism may occur under which condition?
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Question 25 of 85
A nurse is teaching parents about managing iron deficiency anemia in their toddler. What is an appropriate intervention?
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Question 26 of 85
Which statement is true about acute diarrhoea?
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Question 27 of 85
A 10-year-old with hemophilia is admitted for knee swelling after a fall. What is the nurse's priority action?
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Question 28 of 85
Skin fibroblasts to evaluate the ETV6 gene
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Question 29 of 85
Mario is 2 years old, brought to the Well Child Clinic for his regular visit. On physical exam, he had the following anthropometric measurements: Weight - 15 kgs, Height - 90 cms, Head Circumference - 48 cms. On developmental screening, he was able to do the following: could stand momentarily on one foot, draw a circle and imitate a cross, talk in simple sentences and tell a story. Mother claimed that he is dry by night. At 2 years of age, Mario had a height of 85 cms. How tall would he be when he becomes an adult?
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Question 30 of 85
The pathophysiology of venous thrombosis is often explained by Virchow's triad... Based on Virchow's triad and your knowledge of risk factors for thrombosis, which of the following pediatric patients has the greatest risk of hospital-acquired venous thromboembolism?
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Question 31 of 85
Child complains of pain, tenderness or cramps in the stomach around the navel or in the lower right side of the abdomen. Discomfort continues for three hours or more.
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Question 32 of 85
What occurs as a result of an inadequate secretion of insulin?
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Question 33 of 85
Which of the following is a possible indicator of Munchausen syndrome by proxy type of child abuse?
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Question 34 of 85
A 9-week-old infant is scheduled for cleft lip repair. Which information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?
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Question 35 of 85
An 8-year-old boy undergoes a resection of a tumor in the right cerebrum next to the lateral ventricle(supratentorial). The pathologist feels the histology is most consistent with an ependymoma. The tumor is sent for advanced molecular and genetic testing. Which of the following findings would further support a diagnosis of ependymoma?
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Question 36 of 85
Which sign would classify a 9-month-old child with difficult breathing as SEVERE PNEUMONIA OR VERY SEVERE DISEASE?
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Question 37 of 85
For a patient admitted for a sickle cell crisis, what is the priority nursing intervention?
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Question 38 of 85
All of the following are embryonic haemoglobin except-
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Question 39 of 85
What action does a green-coded classification require?
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Question 40 of 85
A young child with consanguineous parents has developmental delay and a history of multiple recurrent bacterial infections and short stature. He presents to the emergency department following trauma and requires a blood transfusion. Blood work identifies leukocytosis, neutrophilia, and the Bombay blood group(absent H antigen as well as absent A and B antigens). What is this patient's diagnosis?
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Question 41 of 85
You are seeing a 13-year-old boy with fatigue, weight loss, night sweats, and splenomegaly. Peripheral blood shows anemia, thrombocytosis, and leukocytosis(300,000/mm3). What is this patient's most likely diagnosis?
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Question 42 of 85
Parents of a child with leukemia are exploring alternative treatments. What is the nurse's best response?
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Question 43 of 85
The nurse is instructing a mother about the nutritional needs of her full-term breastfeeding infant at age 2 months. Which of the following responses show that the mother understands the infant's dietary needs?
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Question 44 of 85
This is a skin eruption that, in infants, usually starts on the cheeks and is red and oozing. Thickening of the skin will occur in older children. It is not contagious.
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Question 45 of 85
A 3-year-old is receiving chemotherapy for a Wilms tumor. The parents ask why radiation is necessary after surgery. What is the nurse's best response?
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Question 46 of 85
A 2-year-old is brought to the clinic with symptoms of fever, inspiratory stridor, a bark-like cough, and mild retractions. What is the most appropriate nursing intervention?
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Question 47 of 85
A newborn was found to have the following anomalies: hydrocephalus, cicatricial scarring over the 6th-7th left intercostals, malformed feet (fusion and maldevelopment of both feet). Which congenital infection shows these findings at birth?
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Question 48 of 85
When teaching a group of new parents about newborn care and development, which immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns?
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Question 49 of 85
A 4-year-old child with acute lymphoblastic leukemia is receiving high-dose methotrexate during interim maintenance. He receives ondansetron and aprepitant during his stay, which control his nausea and vomiting well. These medications work by inhibiting signaling in which part of the brain?
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Question 50 of 85
A young woman presents with a polypoid vascular proliferation of the oral mucosa. The lesion is comprised of a lobular proliferation of small vessels lined by plump endothelial cells with a fibrous connective tissue background. Which of the following statements is true about this entity?
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Question 51 of 85
A 4-year old is admitted with acute leukemia. It will be most important to monitor the child for:
An 18-month old boy presents with a primary testicular tumor. Without even seeing the slide, you bet your morning coffee that he has a:
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Question 55 of 85
The primary reason for AIDS, a deadly disease, is that it-
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Question 56 of 85
A recently hospitalized 2-years-old client scream and shouts he wants a 'bottle'. His parents are puzzled and state he has drunk from a cup for the past year. The nurse explains that:
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Question 57 of 85
An infant weighing 1400 g (3 lb) is born at 32 weeks gestation in a delivery room that has an ambient temperature of 24'C. Within a few minutes of birth, this infant is likely to exhibit all the following EXCEPT:
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Question 58 of 85
The nurse is preparing a teaching plan for the parents of a 6-month-old infant with GERD. What instruction should the nurse include when teaching the parents measures to promote adequate nutrition?
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Question 59 of 85
A 12-year-old patient with localized osteosarcoma is being treated with cisplatin, doxorubicin, and high-dose methotrexate. The pain at his primary site rapidly resolves after initiation of chemotherapy. After tumor resection, pathology reveals the tumor was greater than 95% necrotic. You want to continue cisplatin, doxorubicin, and high-dose methotrexate. Which of the following is the best answer regarding the evaluations that should be performed to monitor for toxicity in patients receiving cisplatin, doxorubicin, and high-dose methotrexate?
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Question 60 of 85
A 10-year-old male with HIV on HART therapy is evaluated for elevated liver enzymes (ALT 119 IU/L, AST 101 IU/L, bilirubin 1.3 mg/dL, Alk Phos 390 IU/L). A liver biopsy showed numerous blood-filled cysts that do not have an endothelial lining. This finding is most likely secondary to:
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Question 61 of 85
How do you classify Shaikh, a 4-week-old not able to breastfeed since morning, axillary temperature 35.4°C, respiratory rate 71 breaths/minute?
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Question 62 of 85
Acquired hypothyroidism is most often due to:
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Question 63 of 85
Which finding in a cerebrospinal fluid(CSF) analysis is consistent with a diagnosis of bacterial meningitis?
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Question 64 of 85
Based on this data given by Braguda, you can classify Braguda's daughter to have:
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Question 65 of 85
Which process is the endocrine system NOT primarily responsible for controlling?
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Question 66 of 85
The 6-year-old child scheduled for an orchiopexy shyly asks the nurse, 'What are they going to do to me 'down there'?' What is the nurse's best response?
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Question 67 of 85
A 3-year-old boy with fever, conjunctivitis, lymphadenopathy, and maculopapular rash is MOST likely to have:
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Question 68 of 85
An overweight adolescent male complains of pain in the medial aspect of his knee. He denies trauma, and he has not had a fever. The most likely diagnosis is:
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Question 69 of 85
Which histological feature found on biopsy during colonoscopy would favour a diagnosis of Crohn disease over ulcerative colitis?
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Question 70 of 85
Hypothermia is common in newborn because of their inability to control heat. The following would be an appropriate nursing intervention to prevent heat loss except:
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Question 71 of 85
An ovarian tumor from a young child is most likely to belong to which GENERAL category?
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Question 72 of 85
Which medication is used in the treatment of heart failure?
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Question 73 of 85
While assessing a newborn with cleft lip, the nurse would be alert that which of the following will most likely be compromised?
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Question 74 of 85
A 13 year old girl is admitted to the ER with lower right abdominal discomfort. The admitting nursing should take which of the following measures first?
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Question 75 of 85
What does the nurse remind the adolescent with diabetes that soluble fiber in the diet can reduce?(Select all that apply.)
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Question 76 of 85
The parents of a 5-year-old ask about home management for their child's mild croup symptoms. What advice should the nurse provide?
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Question 77 of 85
A nurse is planning care for a child who has epiglottitis. Which of the following actions should the nurse plan to take?
While performing an assessment of a client who is immunocompromised, the nurse notes the child to have thrush in the mouth, tenderness over the spleen upon palpation, and a white blood cell count of 3,000. Which nursing diagnosis will the nurse include in the care plan of this child based on these findings?
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Question 80 of 85
A child with hydrocephalus has increased blood pressure, decreased pulse rate, and decreased respirations. What does the nurse suspect these symptoms indicate?
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Question 81 of 85
In which case should karyotyping NOT be considered?
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Question 82 of 85
When assessing the development of a 15 month old child with cerebral palsy, which of the following milestones would the nurse expect a toddler of this age to have achieved?
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Question 83 of 85
When assessing a newborn for developmental dysplasia of the hip, the nurse would expect to assess which of the following?
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Question 84 of 85
A 3-year-old boy is referred to you for evaluation of right leukocoria. Funduscopic examination under anesthesia reveals a large amelanotic mass occupying more than two-thirds of the vitreous space in his right eye, with massive retinal detachment, consistent with group E retinoblastoma. The left eye is normal. An MRI confirms the funduscopic findings and shows no extraocular disease. What is the most appropriate next step in the management of this child's disease?
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Question 85 of 85
A 24-hour old neonate is brought to the ER because of inability to pass meconium in 24 hours. He does not have vomiting or distention. Your recommendation would be to:
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