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1. What are early signs of varicella disease?
- A. High fever over 101°F (38.3°C)
- B. General malaise
- C. Increased appetite
- D. Crusty sores
Correct answer: B
Rationale: The correct early sign of varicella disease is general malaise. During the prodromal period, patients may experience low-grade fever, malaise, and anorexia. Increased appetite and crusty sores are not typically early signs of varicella. The appearance of lesions occurs later in the course of the disease.
2. How are type IV hypersensitivity reactions different from all other types (I, II, or III) of hypersensitivity reactions?
- A. They involve antigen-antibody complexes.
- B. They are mediated by T cells and do not involve antibodies.
- C. They result in immediate allergic reactions.
- D. They are the least severe form of hypersensitivity.
Correct answer: B
Rationale: Type IV hypersensitivity reactions are mediated by T cells and cytokine release, leading to delayed reactions, unlike types I, II, and III, which involve antibodies. Choice A is incorrect because type IV reactions do not involve antigen-antibody complexes. Choice C is incorrect as type IV reactions do not result in immediate allergic reactions. Choice D is incorrect as type IV reactions are not the least severe form of hypersensitivity; in fact, they are known to cause significant tissue damage and inflammation.
3. Which laboratory results should the nurse anticipate to be abnormal in a child with hemophilia?
- A. Prothrombin time
- B. Bleeding time
- C. Platelet count
- D. Partial thromboplastin time
Correct answer: D
Rationale: In a child with hemophilia, the nurse should anticipate an abnormality in the partial thromboplastin time (PTT) due to the deficiency in clotting factors. Prothrombin time, bleeding time, and platelet count are typically normal in hemophilia. Prothrombin time measures the extrinsic pathway of coagulation and is not affected in hemophilia. Bleeding time assesses platelet function, which is normal in hemophilia as the issue lies with clotting proteins, not platelets. Platelet count is also expected to be normal unless there is another underlying condition affecting platelet production or function.
4. What assessment findings should lead the nurse to suspect Down syndrome in a newborn?
- A. Hypertonia and dark skin
- B. Low-set ears and a simian crease
- C. Inner epicanthal folds and a high, domed forehead
- D. Long, thin fingers and excessive hair
Correct answer: B
Rationale: The correct answer is B: 'Low-set ears and a simian crease.' These are key physical characteristics commonly seen in newborns with Down syndrome. Low-set ears, along with a simian crease (a single palmar crease), are indicative of Down syndrome. Choices A, C, and D are incorrect because hypertonia, dark skin, inner epicanthal folds, a high, domed forehead, long, thin fingers, and excessive hair are not specific features associated with Down syndrome in newborns. Therefore, the presence of low-set ears and a simian crease should raise suspicion for Down syndrome and prompt further evaluation.
5. What is the most common clinical manifestation of coarctation of the aorta?
- A. Clubbing of the digits
- B. Upper extremity hypertension
- C. Pedal edema and portal congestion
- D. Loud systolic ejection murmur
Correct answer: B
Rationale: The correct answer is B: Upper extremity hypertension. Coarctation of the aorta leads to increased blood pressure in the upper extremities. The pressure in the arms is typically 20 mm Hg higher than in the legs. Choice A, clubbing of the digits, is not a common clinical manifestation of coarctation of the aorta. Choice C, pedal edema, and portal congestion are more suggestive of conditions like heart failure rather than coarctation of the aorta. Choice D, loud systolic ejection murmur, can be heard in conditions like aortic stenosis, but it is not the most common clinical manifestation of coarctation of the aorta.
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