HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 1 of 74
The parent of a newborn asks, 'Will my baby spit out the formula if it is too hot or too cold?' Select the nurse's best response.
A
Babies tend to reject hot fluids but not cold fluids, which could result in abdominal discomfort.
B
Babies tend to reject cold fluids but not hot fluids, which could result in esophageal burns.
C
Your baby will likely swallow the formula regardless of the temperature because swallowing is a reflex in infants younger than 6 weeks.
D
Your baby is too young to be capable of spitting out fluids.
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 2 of 74
The nurse is caring for a 4-month-old who has just had an isolated cleft lip repaired. Select the best position for the child in the immediate postoperative period.
A
Right side-lying.
B
Left side-lying.
C
Supine.
D
Prone.
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 3 of 74
Direct person-to-person contact outbreaks of gastroenteritis are usually caused by
A
Shigella
B
Salmonella
C
Rotavirus
D
Clostridium difficile
Select an option. Use Strike to cross one out.
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Question 4 of 74
The most common cause of facial swelling without facial tenderness or erythema in the maxillary area of a 12-year-old is
A
localized trauma
B
an abscessed tooth
C
a bee sting
D
Haemophilus influenzae type b
Select an option. Use Strike to cross one out.
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Question 5 of 74
The first factor to be affected by deficiency of vitamin K is
A
Factor I
B
Factor II
C
Factor VII
D
Factor IX
Select an option. Use Strike to cross one out.
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Question 6 of 74
Hypertrophic pyloric stenosis has been associated with the following EXCEPT
A
eosinophilic gastroenteritis
B
Apert syndrome
C
Zellweger syndrome
D
trisomy 21
Select an option. Use Strike to cross one out.
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Question 7 of 74
All the following amino acids are indispensable in human diet EXCEPT
A
leucine
B
threonine
C
methionine
D
alanine
Select an option. Use Strike to cross one out.
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Question 8 of 74
After blunt facial trauma, a 12-year-old appears to have a missing incisor. There is no evidence of the tooth at the scene, and the child does not remember swallowing the tooth. The next step in evaluating the child is
A
plan for a bridge
B
abdominal x-ray to search for the avulsed tooth
C
dental x-ray to look for intrusion
D
ceramic tooth
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 9 of 74
An expectant mother asks the nurse if her new baby will have an umbilical hernia. The nurse bases the response on the fact that it occurs:
A
More often in large infants.
B
In white infants more than in African American infants.
C
Twice as often in male infants.
D
More often in premature infants.
Select an option. Use Strike to cross one out.
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Question 10 of 74
A 5-year-old has a history of chronic recurrent abdominal pain and emesis. A diagnosis of cyclic vomiting was made at 3 years of age. Therapy with antimigraine medications was unsuccessful. During each episode, the serum ammonia, pH, glucose, and bicarbonate were normal. He now manifests bile-stained emesis, a tender distended abdomen, and bright-red blood per rectum. The most likely diagnosis is
A
stress ulcers
B
intussusception
C
malrotation
D
superior mesenteric artery syndrome
Select an option. Use Strike to cross one out.
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Question 11 of 74
Regarding Kayser-Fleischer rings, which of the following is NOT true?
A
might be present in younger children
B
requires slit-lamp examination even in 95% of patients
C
is permanent after treatment
D
is deposition of copper in Descemet's membrane
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 12 of 74
Risks associated with severe dehydration that might necessitate intravenous resuscitation include
A
age < 9 mo
B
postmaturity
C
fever >38°C
D
depressed level of consciousness
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 13 of 74
The nurse is caring for a 14-year-old with celiac disease. The nurse knows that the patient understands the diet instructions by ordering which of the following meals?
A
Eggs, bacon, rye toast, and lactose-free milk.
B
Pancakes, orange juice, and sausage links.
C
Oat cereal, breakfast pastry, and non-fat skim milk.
D
Cheese, banana slices, rice cakes, and whole milk.
Select an option. Use Strike to cross one out.
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Question 14 of 74
During the treatment of malnutrition, the signal of entry to the rehabilitation phase is
A
reduced edema
B
resolution of infection
C
disappearance of signs of micronutrient deficiency
D
constant body temperature
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 15 of 74
Complications of appendicitis include all of the following EXCEPT
A
male sterility
B
hepatic abscess
C
peritonitis
D
intestinal obstruction
Select an option. Use Strike to cross one out.
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Question 16 of 74
The nurse receives a call from the mother of a 6-month-old who describes her child as alternately sleepy and fussy. The infant vomited once this morning and had two episodes of diarrhea; the last episode contained mucus and a small amount of blood. The mother asks what she should do. Select the nurse's best response.
A
Your infant will need to have some tests in the emergency room to determine if anything serious is going on.
B
Try feeding your infant in about 30 minutes; if vomiting repeats, bring the infant to the emergency room for tests and IV rehydration.
C
Many infants display these symptoms when they develop an allergy to the formula; try switching to a soy-based formula.
D
This presentation suggests intussusception, which is an emergency. Please take your child immediately to the emergency room.
Select an option. Use Strike to cross one out.
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Question 17 of 74
One of the following causes osmotic diarrhea
A
Escherichia coli
B
carcinoid
C
neuroblastoma
D
congenital chloride malabsorption
Select an option. Use Strike to cross one out.
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Question 18 of 74
The nurse is caring for a 9-month-old with diarrhea secondary to rotavirus. The child has not vomited and is mildly dehydrated. Which is likely to be included in the discharge teaching?
A
Administer Imodium as needed.
B
Administer Kaopectate as needed.
C
Continue breastfeeding per routine.
D
The infant may return to day care 24 hours after antibiotics have been started.
Select an option. Use Strike to cross one out.
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Question 19 of 74
The Alvarado/MANTRELS rule for diagnosis of acute appendicitis gives 2 points for
A
migration of pain to the right lower quadrant
B
anorexia
C
rebound pain
D
WBC shift to greater than 75% neutrophils
Select an option. Use Strike to cross one out.
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Question 20 of 74
Oral treatment of iron deficiency anemia should be continued for
A
2 months
B
3 months
C
6 months
D
12 months
Select an option. Use Strike to cross one out.
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Question 21 of 74
An 8-month-old manifests fussiness and emesis and refuses to eat. At presentation to the hospital on the second day of admission, he is difficult to arouse. Vital signs are normal, there is abdominal distention, and the rectal examination reveals occult blood in the stool. The most likely diagnosis is
A
food poisoning
B
colic
C
intussusception
D
infant botulism
Select an option. Use Strike to cross one out.
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Question 22 of 74
In abetalipoproteinemia, the following is seen in the peripheral blood smear EXCEPT
A
presence of acanthocytes
B
extremely low plasma levels of cholesterol
C
very low triglycerides
D
normal intellectual development
Select an option. Use Strike to cross one out.
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Question 23 of 74
The most common indication for liver transplantation in children is
A
Alagille syndrome
B
congenital hepatic fibrosis
C
hepatocellular carcinoma
D
biliary atresia
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 24 of 74
In healthy full-term infants, meconium is passed within 48 hours of birth in
A
99%
B
90%
C
80%
D
70%
Select an option. Use Strike to cross one out.
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Question 25 of 74
The clinical manifestations of vitamin A deficiency in humans appear as a group of ocular signs termed xerophthalmia. Of the following, the EARLIEST manifestation is
A
night blindness
B
xerosis of the conjunctiva and cornea
C
corneal ulceration
D
keratomalacia
Select an option. Use Strike to cross one out.
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Question 26 of 74
Concerns to be considered among vegetarians are all the following EXCEPT
A
higher bioavailability of iron
B
lower B12 levels
C
risk of having lower levels of fatty acids
D
lower levels of calcium and vitamin D
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 27 of 74
Complications of appendicitis include
A
Wound infection
B
Intra-abdominal abscess
C
Infertility
D
All of the above
Select an option. Use Strike to cross one out.
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Question 28 of 74
Gastroesophageal reflux in children may be associated with all of the following EXCEPT
A
Sandifer syndrome
B
esophagitis
C
aspiration pneumonia
D
pylorospasm
Select an option. Use Strike to cross one out.
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Question 29 of 74
All are true about Crohn disease and ulcerative colitis (IBD) EXCEPT
A
the risk of IBD is higher if a family member is affected by IBD
B
Crohn disease carries a higher risk of malignancy than does ulcerative colitis
C
the two diseases may be present in the same family
D
there is an association between IBD and glycogen storage disease type 1b
Select an option. Use Strike to cross one out.
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Question 30 of 74
Potential causes of constipation include all of the following EXCEPT
A
hypothyroidism
B
hypokalemia
C
lead
D
ibuprofen
Select an option. Use Strike to cross one out.
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Question 31 of 74
A 1-day-old neonate of 35 weeks of gestational age presents with drooling and respiratory distress. A nasogastric tube is placed, oxygen is given, and a chest x-ray obtained. After reviewing the chest x-ray, Figure 17-1, the most likely diagnosis is
A
meconium aspiration pneumonia
B
tracheoesophageal fistula
C
tetralogy of Fallot
D
foreign body
Select an option. Use Strike to cross one out.
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Question 32 of 74
Dysphagia is best described as
A
pain on swallowing
B
emesis without nausea
C
drooling due to obstruction
D
difficulty swallowing
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 33 of 74
The major minerals are those that require intakes of more than 100 mg/day and contribute at least 0.1% of total body weight. All the following are essential major minerals EXCEPT
A
calcium
B
phosphorus
C
magnesium
D
iron
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 34 of 74
All of the following are features of achalasia EXCEPT
A
dysphagia for solids and liquids
B
may be accompanied by undernutrition
C
may be misdiagnosed as asthma
D
usually diagnosed before school age
Select an option. Use Strike to cross one out.
HESI LPN · LPN Pediatric Gastrointestinal Nursing Interventions
Question 35 of 74
The MOST profound consequence of undernutrition is
A
premature death
B
repeated infections
C
stunting
D
developmental delay
Select an option. Use Strike to cross one out.
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Question 36 of 74
A healthy 3-year-old boy reports to his mother that he accidentally swallowed a small plastic toy and is brought to the emergency department for evaluation. The mother recalls that the other toys in the playset are all 1 to 2 cm in length and have no sharp edges. On examination, the child appears to be in no distress and is playing in the examination room with his sister. His vital signs are normal. Of the following, the BEST next step is
A
barium swallow and meal imaging
B
observation
C
chest and abdominal radiograph series
D
upper endoscopy to remove the toy
Select an option. Use Strike to cross one out.
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Question 37 of 74
Which child may need extra fluids to prevent dehydration? (Select all that apply.)
A
7-day-old receiving phototherapy.
B
6-month-old with newly diagnosed pyloric stenosis.
C
2-year-old with pneumonia.
D
13-year-old who has just started her menses.
Select an option. Use Strike to cross one out.
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Question 38 of 74
Thiamine-responsive megaloblastic anemia syndrome is characterized by the following EXCEPT
A
diabetes mellitus
B
peripheral neuritis
C
megaloblastic anemia
D
sensorineural hearing loss
Select an option. Use Strike to cross one out.
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Question 39 of 74
The following are characteristic features of acute hypervitaminosis A EXCEPT
A
diplopia
B
cranial nerve palsies
C
seizures
D
nausea and vomiting
Select an option. Use Strike to cross one out.
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Question 40 of 74
All the following are features of hereditary folate malabsorption EXCEPT
A
anal ulcers
B
failure to thrive
C
chronic diarrhea
D
Opportunistic infections
Select an option. Use Strike to cross one out.
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Question 41 of 74
One of the following rules out biliary atresia
A
history of prematurity
B
normal size of liver
C
normal consistency of liver
D
consistently pigmented stools
Select an option. Use Strike to cross one out.
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Question 42 of 74
Acquired causes of gastric outlet obstruction include all of the following EXCEPT
A
cystic fibrosis
B
epidermolysis bullosa
C
prostaglandin E infusions
D
eosinophilic gastritis
Select an option. Use Strike to cross one out.
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Question 43 of 74
Ondansetron is an effective adjunct to the treatment of vomiting and is usually given
A
intravenously
B
intramuscularly
C
orally
D
sublingually
Select an option. Use Strike to cross one out.
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Question 44 of 74
The best indicator of body ascorbate stores is
A
leukocyte ascorbate concentration
B
plasma ascorbate level
C
urinary ascorbate level
D
amino acid level
Select an option. Use Strike to cross one out.
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Question 45 of 74
The following might reflect physical features associated with obesity in a 10-year-old boy, EXCEPT
A
hip pain
B
delayed sleep
C
polyuria
D
nocturia
Select an option. Use Strike to cross one out.
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Question 46 of 74
The usual presenting symptoms of peptic ulcer disease in infants and younger children are the following EXCEPT
A
feeding difficulty
B
vomiting
C
epigastric pain
D
hematemesis
Select an option. Use Strike to cross one out.
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Question 47 of 74
All of the following conditions are associated with a higher incidence of inguinal hernia EXCEPT
A
Cystic fibrosis
B
A family history of inguinal hernia
C
Adrenogenital syndrome
D
Testicular feminization syndrome
Select an option. Use Strike to cross one out.
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Question 48 of 74
Risk factors for HBV infection in children and adolescents include all the following EXCEPT
A
intravenous drug use
B
contact with contaminated needles
C
sexual contact
D
sharing toys
Select an option. Use Strike to cross one out.
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Question 49 of 74
The hallmark of refeeding syndrome is the development of severe
A
hypophosphatemia
B
hypokalemia
C
hypomagnesemia
D
hypernatremia
Select an option. Use Strike to cross one out.
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Question 50 of 74
The following hereditary forms of rickets may help to diagnose an apparently healthy mother with the same disease
A
X-linked hypophosphatemic rickets
B
autosomal dominant hypophosphatemic rickets
C
autosomal recessive hypophosphatemic rickets
D
Fanconi syndrome
Select an option. Use Strike to cross one out.
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Question 51 of 74
An 11-year-old Tanner stage 2 female experiences intermittent periumbilical abdominal pain 2 days before emergently visiting her pediatrician. Six hours later, she is nauseated and has one or two episodes of emesis. She also has had two soft bowel movements without blood or relief of symptoms. She walks cautiously into your office and lies still on your examining table. When you begin your examination, she is apprehensive and watches every move of your examining hand. You notice guarding and tenderness throughout her abdomen; the most tender area is the right lower quadrant. The most likely diagnosis is
A
Pelvic inflammatory disease
B
Ruptured ectopic pregnancy
C
Crohn disease
D
Appendicitis
Select an option. Use Strike to cross one out.
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Question 52 of 74
Vitamin B12 is important for all of the following EXCEPT
A
nematopoiesis
B
skeletal development
C
psychomotor development
D
central nervous system myelination
Select an option. Use Strike to cross one out.
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Question 53 of 74
Pyridoxine is not affected in patients receiving
A
isoniazid
B
valproate
C
phenytoin
D
corticosteroids
Select an option. Use Strike to cross one out.
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Question 54 of 74
The MOST common congenital disorder associated with exocrine pancreatic insufficiency is
A
Shwachman Diamond syndrome
B
Johanson-Blizzard syndrome
C
Pearson bone marrow syndrome
D
cystic fibrosis
Select an option. Use Strike to cross one out.
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Question 55 of 74
Rectal examination is helpful in children with which of the following?
A
acute diarrhea
B
chronic diarrhea
C
anal itching
D
jaundice
Select an option. Use Strike to cross one out.
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Question 56 of 74
Pill ulcers occur when certain medications are swallowed without sufficient liquids, allowing prolonged direct contact of the pill with the esophageal mucosa. Of the following, the MOST accused one is
A
acetazolamide
B
methyldopa
C
carbamazepine
D
tetracycline
Select an option. Use Strike to cross one out.
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Question 57 of 74
A 5-year-old boy presented with obesity, syndactyly, infantile genitalia, and mental retardation. Fundoscopy revealed retinal degeneration, the parents are first cousin. Of the following, the MOST likely cause of his obesity is
A
Alström syndrome
B
Laurence-Moon-Bardet-Biedl
C
Fröhlich syndrome
D
Prader-Willi syndrome
Select an option. Use Strike to cross one out.
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Question 58 of 74
The nurse is caring for a newborn with esophageal atresia. When reviewing the mother's history, which would the nurse expect to find?
A
Maternal polyhydramnios.
B
Pregnancy lasting more than 38 weeks.
C
Poor nutrition during pregnancy.
D
Alcohol consumption during pregnancy.
Select an option. Use Strike to cross one out.
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Question 59 of 74
The nurse is caring for an infant who has been diagnosed with short bowel syndrome (SBS). The parent asks how the disease will affect the child. Select the nurse's best response.
A
Because your child has a shorter intestine than most, your child will likely experience constipation and will need to be placed on a bowel regimen.
B
Because your child has a shorter intestine than most, he will not be able to absorb all the nutrients and vitamins in food and will need to get nutrients in other ways.
C
Unfortunately, most children with this diagnosis do not do very well.
D
The prognosis and course of the disease have changed because hyperalimentation (parenteral nutrition) is available.
Select an option. Use Strike to cross one out.
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Question 60 of 74
One of the following studies may be helpful in discovering the cause behind small bowel atresia
A
immunoglobulin assay
B
chloride sweat test
C
liver function tests
D
serum electrolytes
Select an option. Use Strike to cross one out.
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Question 61 of 74
Secretory diarrhea can be caused by all of the following EXCEPT
A
laxative abuse
B
lactase deficiency
C
irritable bowel syndrome
D
thyrotoxicosis
Select an option. Use Strike to cross one out.
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Question 62 of 74
The anorectal defect most frequently encountered in male patients is
A
perineal fistula
B
rectourethral fistula
C
rectum-bladder neck fistula
D
imperforate anus without a fistula
Select an option. Use Strike to cross one out.
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Question 63 of 74
Which should the nurse include in the plan of care to decrease symptoms of gastroesophageal reflux (GER) in a 2-month-old? (Select all that apply.)
A
Place the infant in an infant seat immediately after feedings.
B
Place the infant in the prone position immediately after feeding to decrease the risk of aspiration.
C
Encourage the parents not to worry because most infants outgrow GER within the first year of life.
D
Encourage the parents to hold the infant in an upright position for 30 minutes following a feeding.
Select an option. Use Strike to cross one out.
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Question 64 of 74
Regarding Johanson-Blizzard syndrome, which of the following is NOT true?
A
more common in boys
B
exocrine pancreatic deficiency
C
congenital hypoplasia of the scalp
D
ectodermal defects
Select an option. Use Strike to cross one out.
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Question 65 of 74
Micrognathia and cleft palate are common associations with which of the following?
A
osteogenesis imperfecta
B
ectodermal dysplasia
C
Pierre Robin syndrome
D
mandibulofacial dysostosis
Select an option. Use Strike to cross one out.
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Question 66 of 74
Smooth tongue in nutritional deficiency disorders of childhood is usually caused by deficiency of
A
iron
B
copper
C
biotin
D
iodine
Select an option. Use Strike to cross one out.
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Question 67 of 74
Which manifestation suggests that an infant is developing necrotizing enterocolitis (NEC)?
A
Absorption of bolus orogastric feedings at a faster rate than previous feedings.
B
Bloody diarrhea.
C
Increased bowel sounds.
D
Appears hungry right before a scheduled feeding.
Select an option. Use Strike to cross one out.
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Question 68 of 74
Features dominant in X-linked hypophosphatemic rickets are
A
craniotabes, frontal bossing, and rickets
B
scoliosis and lordosis
C
rachitic rosary and Harrison groove
D
coxa vara and windswept deformity
Select an option. Use Strike to cross one out.
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Question 69 of 74
Of the following, the MOST sensitive and specific test in the evaluation of children with suspected appendicitis is
A
leukocyte count
B
urinalysis
C
C-reactive protein
D
serum amyloid A protein
Select an option. Use Strike to cross one out.
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Question 70 of 74
Of the following, the MOST severe complication of total parenteral nutrition (TPN) that can cause a variety of liver diseases is
A
hepatic steatosis
B
gallbladder damage
C
bile duct damage
D
cholestasis
Select an option. Use Strike to cross one out.
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Question 71 of 74
All the following infections are associated with vitamin D deficiency EXCEPT
A
otitis media
B
urinary tract infections
C
septicemia
D
childhood cancer
Select an option. Use Strike to cross one out.
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Question 72 of 74
All the following are features of Stickler syndrome EXCEPT
A
prominent joints
B
autosomal recessive inheritance
C
hypotonia
D
retinal detachment
Select an option. Use Strike to cross one out.
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Question 73 of 74
The nurse is providing discharge instructions to the parents of a child who had an appendectomy for a ruptured appendix 5 days ago. The nurse knows that further education is required when the parent states:
A
We will wait a few days before allowing our child to return to school.
B
We will wait 2 weeks before allowing our child to return to sports.
C
We will call the pediatrician's office if we notice any drainage around the wound.
D
We will encourage our child to go for walks every day.
Select an option. Use Strike to cross one out.
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Question 74 of 74
All the following matchings' between drugs and vitamin and nutrient deficiency states are true EXCEPT
A
sulfonamides = folate
B
phenytoin = vitamins D
C
antibiotics = vitamin K
D
isoniazid = vitamin B12
Select an option. Use Strike to cross one out.