please discuss your thoughts on the following topics with respect to your upcoming pediatric clinical experience:

● Importance of pediatric growth and development knowledge
● Differences in communicating with the child and family versus the adult client
● Importance of including culture and age-appropriate interventions in the care of the child

Question

1. Question : Continued therapy of pernicious anemia (PA) generally lasts how long?

6 to 8 weeks

8 to 12 months

Until the iron level is normal

The rest of one’s life

Question 2. : What pulmonary defense mechanism propels a mucous blanket that entraps particles moving toward the oropharynx?

Nasal turbinates

Alveolar macrophages

Cilia

Irritant receptors on the nares

Question 3. : The common hay fever allergy is expressed through a reaction that is mediated by which class of immunoglobulins?

IgE

IgG

IgM

T cells

Question 4. : Which of the following describes how the body compensates for anemia?

Increasing rate and depth of breathing

Decreasing capillary vasoconstriction

Hemoglobin holding more firmly onto oxygen

Kidneys releasing more erythropoietin

Question 5. : Obesity creates a greater risk for dehydration in people because:

Adipose cells contain little water because fat is water repelling.

The metabolic rate of obese adults is slower than the rate of lean adults.

The rate of urine output of obese adults is higher than the rate of output of lean adults.

The thirst receptors of the hypothalamus do not function effectively.

Question 6. : Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?

Norepinephrine

Epinephrine

Cortisol

Adrenocorticotropic hormone (ACTH)

Question 7. : What is the treatment of choice for pernicious anemia (PA)?

Cyanocobalamin by oral intake

Vitamin B₁₂ by injection

Ferrous fumarate by Z-track injection

Folate by oral intake

Question 8. : Which sexually transmitted infection frequently coexists with gonorrhea?

Syphilis

Herpes simplex virus

Chlamydia

Chancroid

Question 9. : During an infection, why do lymph nodes enlarge and become tender?

B lymphocytes proliferate.

The nodes are inflamed.

The nodes fill with purulent exudate.

The nodes are not properly functioning.

Question 10. : Chvostek and Trousseau signs indicate which electrolyte imbalance?

Hypokalemia

Hyperkalemia

Hypocalcemia

Hypercalcemia

Question 11. : What is the suggested mean blood pressure for an 8- to 9-year-old child?

104/55 mm Hg

106/58 mm Hg

112/62 mm Hg

121/70 mm Hg

Question 12. : Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of:

Epinephrine and aldosterone

Norepinephrine and cortisol

Epinephrine and norepinephrine

Acetylcholine and cortisol

Question 13. : Bronchiolitis tends to occur during the first years of life and is most often caused by what type of infection?

Respiratory syncytial virus (RSV)

Influenzavirus

Adenoviruses

Rhinovirus

Question 14. : What is the function of erythrocytes?

Tissue oxygenation

Hemostasis

Infection control

Allergy response

Question 15. : The tonic neck reflex observed in a newborn should no longer be obtainable by:

2 years

1 year

10 months

5 months

Question 16. Where are Kupffer cells located?

Kidneys

Liver

Pancreas

Spleen

Question 17. Stress-induced norepinephrine results in:

Pupil constriction

Peripheral vasoconstriction

Increased sweat gland secretions

Decreased blood pressure

Question 18. Which normal physiologic change occurs in the aging pulmonary system?

Decreased flow resistance

Fewer alveoli

Stiffening of the chest wall

Improved elastic recoil

Question 19. Which statement accurately describes childhood asthma?

An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation

A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging

A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens

An obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency

Question 20. In which structure does B lymphocytes mature and undergo changes that commit them to becoming B cells?

Thymus gland

Regional lymph nodes

Bone marrow

Spleen

Question 21. Tissue damage caused by the deposition of circulating immune complexes containing an antibody against the host DNA is the cause of which disease?

Hemolytic anemia

Pernicious anemia

Systemic lupus erythematosus

Myasthenia gravis

Question 22. Where are Langerhans cells found?

Skin

Intestinal lining

Kidney

Thyroid

Question 23. What is the most commonly reported symptom of cancer treatment?

Nausea

Fatigue

Hair loss

Weight loss

Question 24. Cystic fibrosis is caused by which process?

Autosomal recessive inheritance

Autosomal dominant inheritance

Infection

Malignancy

Question 25. What is the primary cause of the symptoms of polycythemia vera?

Decreased erythrocyte count

Destruction of erythrocytes

Increased blood viscosity

Neurologic involvement

Question 26. What term is used to describe a hernial protrusion of a saclike cyst that contains meninges, spinal fluid, and a portion of the spinal cord through a defect in a posterior arch of a vertebra?

Encephalocele

Meningocele

Spina bifida occulta

Myelomeningocele

Question 27. How is the effectiveness of vitamin B12 therapy measured?

Reticulocyte count

Serum transferring

Hemoglobin

Serum vitamin B12

Question 28. The ability of the pathogen to invade and multiply in the host is referred to as:

Infectivity

Toxigenicity

Pathogenicity

Virulence

Question 29. Which is an example of an endogenous antigen?

Yeast

Cancer cells

Bacteria

Fungus

Question 30. Which immunoglobulin is present in blood, saliva, breast milk, and respiratory secretions?

IgA

IgE

IgG

IgM

Question 31. Which blood cells are the chief phagocytes involved in the early inflammation process?

Neutrophils

Monocytes

Eosinophils

Erythrocytes

Question 32. Which renal change is found in older adults?

Sharp decline in glomerular filtration rate

Sharp decline in renal blood flow

Decrease in the number of nephrons

Decrease in urine output

Question 33. A hypersensitivity reaction that produces an allergic response is called:

Hemolytic shock

Anaphylaxis

Necrotizing vasculitis

Systemic erythematosus

Question 34. What period follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated?

Refractory

Hyperpolarization

Threshold

Sinoatrial (SA)

Question 35. What is the most common predisposing factor to obstructive sleep apnea in children?

Chronic respiratory infections

Adenotonsillar hypertrophy

Obligatory mouth breathing

Paradoxic breathing

Question 36. Kidney stones in the upper part of the ureter would produce pain referred to which anatomical area?

Vulva or penis

Umbilicus

Thighs

Lower abdomen

Question 37. Aspiration is most likely to occur in the right mainstem bronchus because it:

Extends vertically from the trachea.

Is narrower than the left mainstem bronchus.

Comes into contact with food and drink first.

Is located at the site where the bronchi bifurcate.

Question 38. Blood cells that differentiate into macrophages are known as:

Monocytes

Neutrophils

Eosinophils

Basophils

Question 39. What characteristic do atopic individuals have that make them genetically predisposed to develop allergies?

Greater quantities of histamine

More histamine receptors

Greater quantities of IgE

A deficiency in epinephrine

Question 40. Pressure in the left ventricle must exceed pressure in which structure before the left ventricle can eject blood?

Superior vena cava

Aorta

Inferior vena cava

Pulmonary veins

Question 41. How does chest wall compliance in an infant differ from that of an adult?

An adult’s chest wall compliance is lower than an infant’s.

An adult’s chest wall compliance is higher than an infant’s.

An adult’s chest wall compliance is the same as an infant’s.

An adult’s chest wall compliance is dissimilar to that of an infant’s.

Question 42. In a full-term infant, the normal erythrocyte life span is _____ days, whereas the adult erythrocyte life span is _____ days.

30 to 50; 80

60 to 80; 120

90 to 110; 140

120 to 130; 150

Question 43. Which type of microorganism reproduces on the skin?

Viruses

Bacteria and fungi

Protozoa and Rickettsiae

Mycoplasma

Question 44. An infant diagnosed with a small patent ductus arteriosus (PDA) would likely exhibit which symptom?

Intermittent murmur

Lack of symptoms

Need for surgical repair

Triad of congenital defects

Question 45. Oxygenated blood flows through which vessel?

Superior vena cava

Pulmonary veins

Pulmonary artery

Coronary veins

Question 46. : Why is the herpes virus inaccessible to antibodies after the initial infection?

The virus does not circulate in the blood.

It does not have antibody receptors.

It resists agglutination.

The virus is a soluble antigen.

Question 47. What type of immunity is produced when an immunoglobulin crosses the placenta?

Passive-acquired immunity

Active-acquired immunity

Passive-innate immunity

Active-innate immunity

Question 48. The concentration of the final urine is determined by antidiuretic hormone (ADH), which is secreted by which gland?

Posterior pituitary

Thyroid

Parathyroid

Anterior pituitary

Question 49. Exhaustion occurs if stress continues when which stage of the general adaptation syndrome is notsuccessful?

Flight or fight

Alarm

Adaptation

Arousal

Question 50. When the maternal immune system becomes sensitized against antigens expressed by the fetus, what reaction occurs?

T-cell immunity

Alloimmunity

Fetal immunity

Autoimmunity

Question 51. Which bones are affected in Legg-Calvé-Perthes disease?

Heads of the femur

Distal femurs

Heads of the humerus

Distal tibias

Question 52. What is the basic structural unit in compact bone?

Small channels called canaliculi

Osteocytes within the lacunae

Tiny spaces within the lacunae

Haversian system

Question 53. Which type of fracture usually occurs in an individual who engages in a new activity that is strenuous and repetitive?

Stress

Greenstick

Insufficiency

Pathologic

Question 54. Antipsychotic drugs block which neurotransmitter receptor?

Norepinephrine

Gamma-aminobutyric acid

Serotonin

Dopamine

Question 55. Which risk factor for hypertension is influenced by genetic factors and lifestyle?

Sodium intake

Physical inactivity

Psychosocial stress

Obesity

Question 56. : Where is oxytocin synthesized?

Hypothalamus

Paraventricular nuclei

Anterior pituitary

Posterior pituitary

Question 57. An insufficient dietary intake of which vitamin can lead to rickets in children?

C

B12

B6

D

Question 58. When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of what type of effect by a hormone?

Pharmacologic

Permissive

Synergistic

Direct

Question 59. Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is inhibited when plasma levels of TH are adequate. This is an example of:

Positive feedback

Negative feedback

Neural regulation

Physiologic regulation

Question 60. At 2 or 3 weeks of age, an infant who has been well fed and has gained weight begins to vomit for no apparent reason. The vomiting gradually becomes more forceful. These symptoms may be indicative of which disorder?

Esophageal atresia

Congenital aganglionic megacolon

Pyloric stenosis

Galactosemia

Question 61. Neurofibrillary tangles characterize which neurologic disorder?

Dementia syndrome

Delirium

Alzheimer disease

Parkinson disease

Question 62. What is the target tissue for prolactin-releasing factor?

Hypothalamus

Anterior pituitary

Mammary glands

Posterior pituitary

Question 63. A child with which genetic disorder has a characteristic cry?

Down syndrome

Klinefelter syndrome

Turner syndrome

Cri du chat

Question 64. Which structure attaches skeletal muscle to bone?

Tendon

Ligament

Bursa

Mesentery

Question 65. Which condition poses the highest risk for a cerebrovascular accident (CVA)?

Insulin-resistant diabetes mellitus

Hypertension

Polycythemia

Smoking

Question 66. Which type of diarrhea results from lactose intolerance?

Secretory

Motility

Osmotic

Small volume

Question 67. The most critical aspect in correctly diagnosing a seizure disorder and establishing its cause is:

Computed tomographic (CT) scan

Cerebrospinal fluid analysis

Skull x-ray studies

Health history

Question 68. Which medical diagnosis is characterized by tissue degeneration or irritation of the extensor carpi radialis brevis tendon?

Lateral epicondylitis

Medial tendinitis

Bursitis

Lateral tendinitis

Question 69. Which change is a result of puberty and defends the vagina from infection?

The pH stabilizes between 7 and 8.

A thin squamous epithelial lining develops.

Vaginal pH becomes more acidic.

Estrogen levels are low.

Question 70. The number of persons living with a specific disease at a specific point in time is referred to by which term?

Relativity

Survivability

Prevalence

Incidence

Question 71. : Which hormone is involved in the regulation of serum calcium levels?

Parathyroid hormone (PTH)

Thyroxine (T4)

Adrenocorticotropic hormone (ACTH)

Triiodothyronine (T3)

Question 72. : The secretion of adrenocorticotropic-stimulating hormone (ACTH) will result in the increased level of which hormone?

Thyroxine

Insulin

Cortisol.

Antidiuretic hormone

Question 73. : What happens to the vagina’s lining at puberty?

It becomes thinner.

It becomes thicker.

It assumes a neutral pH.

It undergoes atrophy.

Question 74. : In 95% of children of delayed puberty, the problem is caused by:

Disruption in the hypothalamus

Disruption of the pituitary

Deficit in estrogen or testosterone

Physiologic hormonal delays

Question 75. : Adoption studies have shown that the offspring of an alcoholic parent when raised by nonalcoholic parents have what amount of an increased risk of developing alcoholism?

Twofold

Threefold

Fourfold

Tenfold

Question 76. : What directly causes ovulation during the menstrual cycle?

Gradual decrease in estrogen levels

Sudden increase of LH

Sharp rise in progesterone levels

Gradual increase in estrogen levels

Question 77. : The major sleep center is located in which section of the brain?

Thalamus

Brainstem

Frontal lobe

Hypothalamus

Question 78. : What is the second most commonly recognized genetic cause of mental retardation?

Down syndrome

Fragile X syndrome

Klinefelter syndrome

Turner syndrome

Question 79. : Which person is at the greatest risk for developing delirium?

An individual with diabetes celebrating a 70th birthday

A depressed Hispanic woman

An individual on the second day after hip replacement

A man diagnosed with schizophrenia

Question 80. : Which hormone triggers uterine contractions?

Thyroxine

Oxytocin

Growth hormone

Insulin

Question 81. Question : What is the risk for the recurrence of autosomal dominant diseases?

10%

30%

50%

70%

Question 82. : A person with 47, XXY karyotype has the genetic disorder resulting in which syndrome?

Turner

Klinefelter

Down

Fragile X

Question 83. : The failure of bones to ossify, resulting in soft bones and skeletal deformity, characterizes which disorder?

Osteogenesis imperfecta

Rickets

Osteochondrosis

Legg-Calvé-Perthes disease

Question 84. : What effect does hyperphosphatemia have on other electrolytes?

Increases serum calcium.

Decreases serum calcium.

Decreases serum magnesium.

Increases serum magnesium.

Question 85. : What term is used to identify an interlacing bundle of dense, white fibrous tissue that is richly supplied with nerves, blood vessels, and lymphatic vessels?

Procallus

Joint capsule

Hematoma

Elastin fibers

Question 86. : Where is the usual site of cervical dysplasia or cancer in situ?

Squamous epithelium of the cervix meets the cuboidal epithelium of the vagina.

Columnar epithelium of the cervix meets the squamous epithelium of the uterus.

Squamous epithelium of the cervix meets the columnar epithelium of the uterus.

Columnar epithelium of the cervix meets the squamous epithelium of the vagina.

Question 87. : What is the most common malignant bone tumor diagnosed during childhood?

Chondrosarcoma

Fibrosarcoma

Ewing Sarcoma

Osteosarcoma

Question 88. Question : Obesity acts as an important risk factor for type 2 diabetes mellitus by:

Reducing the amount of insulin the pancreas produces

Increasing the resistance to insulin by cells

Obstructing the outflow of insulin from the pancreas

Stimulating the liver to increase glucose production

Question 89. What is the cause of familial hypercholesterolemia (FH)?

Diet high in saturated fats

Increased production of cholesterol by the liver

Reduction in the number of low-density lipoprotein (LDL) receptors on cell surfaces

Abnormal function of lipoprotein receptors circulating in the blood

Question 90. How do the clinical manifestations and onset of juvenile rheumatoid arthritis (JRA) differ from those of rheumatoid arthritis (RA) in adults?

JRA begins insidiously with systemic signs of inflammation.

JRA predominantly affects large joints.

JRA has more severe joint pain than adult RA.

JRA has a rapid onset of generalized aches as the first symptom.

Question 91. Question : Which clinical manifestations are associated with fibromyalgia?

Hot, tender, and edematous muscle groups bilaterally

Fasciculations of the upper and lower extremity muscles

Exercise intolerance and painful muscle cramps

Sensitivity at tender points and profound fatigue

Question 92. Question : Parkinson disease is a degenerative disorder of the brain’s:

Hypothalamus

Anterior pituitary

Frontal lobe

Basal ganglia

Question 93. Open-angle glaucoma occurs because of:

Decreased production of aqueous humor

Increased production of vitreous humor

Obstructed outflow of aqueous humor

Excessive destruction of vitreous humor

Question 94. Question : A complex partial seizure is described as:

Alternating of tonic and clonic movements

Impairment of both consciousness and the ability to react to exogenous stimuli

Focal motor movement without loss of consciousness

One seizure followed by another in less than 1 minute

Question 95. Why is prolonged diarrhea more severe in children than it is in adults?

Less water is absorbed from the colon in children.

Fluid reserves are smaller in children.

Children have a higher fluid volume intake.

Children have diarrhea more often than adults.

Question 96. Question : What is the blood type of a person who is heterozygous, having A and B alleles as codominant?

A

B

O

AB

Question 97. Question : The mucosal secretions of the cervix secrete which immunoglobulin?

IgA

IgE

IgG

IgM

Question 98. Question : Which clinical manifestations would be expected for a child who has complete trisomy of the twenty-first chromosome?

Widely spaced nipples, reduced carrying angle at the elbow, and sparse body hair

An IQ of 25 to 70, low nasal bridge, protruding tongue, and flat, low-set ears

High-pitched voice, tall stature, gynecomastia, and an IQ of 60 to 90

Circumoral cyanosis, edema of the feet, short stature, and mental slowness

Question 99. Dilation of the ipsilateral pupil, following uncal herniation, is the result of pressure on which cranial nerve (CN)?

Optic (CN I)

Abducens (CN VI)

Oculomotor (CN III)

Trochlear (CN IV)

Question 100. Question : A criterion for a diagnosis of generalized anxiety disorder (GAD) is a period of excessive worrying that lasts for at least how many months?

3

6

9

12

 

NRS-410V Module 4 Mandatory DQ – Chest X-Ray..9

Pathophysiology and Nursing Management of Clients Health – Alterations in Pulmonary and Kidney Function

Use the image in “Discussion Question Resource: Chest X-Ray” to answer the following Critical Thinking Questions.

Examine the x-ray of a patient diagnosed with pneumonia due to infection with Mucor. Refer to the “Module 4 DQ Chest Xray” resource in order to complete the following questions.

Critical Thinking Questions:

1.Explain what Mucor is and how a patient is likely to become infected with Mucor. Describe the pathophysiologic progression of the infection into pneumonia and at least two medical/nursing interventions that would be helpful in treating the patient.

2.Examine the laboratory blood test results and arterial blood gases provided in “Discussion Question Resource: Laboratory Blood Test Results.” What laboratory values are considered abnormal? Explain each abnormality and discuss the probable causes from a pathophysiologic perspective.

3.What medications and medical treatments are likely to be prescribed by the attending physician on this case? List at least three medications and three treatments. Provide rationale for each of the medications and treatments you suggest.