NURS 629 Week 13 Med Challenger, Questions with 100% Correct Answers. Latest.Question 1
Edited: Jul 24, 2018
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A 9-month-old female
... [Show More] infant presents with fever, altered mental status, and
rash. She was seen in the after-hours clinic yesterday with fever and sore
throat, but her parents had difficulty waking her this morning. She has a heart
rate of 189 beats/minute, blood pressure of 65/30 mm Hg, and a blood
glucose level of 40 mg/dL.
Further examination shows her to be poorly responsive with purpuric lesions
on her extremities. While in the pediatric intensive care unit, her blood
pressure continues to be low and is resistant to many interventions.
The most likely explanation for the severity of her presentation is which of the
following?
acute adrenal insufficiency
Question 2
Edited: Jul 24, 2018
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A 13-year-old girl complains of weakness, lethargy, and fatigue. She has a
history of abdominal pain, anorexia, vomiting, and weight loss. Her systolic
blood pressure is low normal and her pulse is weak. Heart sounds are faint
and there is orthostatic hypotension, but her extremities are warm and well
perfused. There is hyperpigmentation of the body prominences and sunexposed skin areas.
Of the following, the most likely diagnosis in this patient is which of the
following?
Addison disease
Question 3
Edited: Jul 24, 2018
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An 8-year-old girl presents with 2 weeks of polydipsia and polyuria. She
developed emesis overnight and is now complaining of abdominal pain.
Before obtaining any laboratory information, the most important part of your
history and examination should be which of the following?
volume status
Question 4
Edited: Jul 24, 2018
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A 16-year-old African American girl presents to you for a well-child visit. Her
weight is 223 pounds, and she is 5 foot 3 inches tall. On examination, you
note darkened skin with a velvety texture around the nape of her neck. The
rest of her examination is normal. Routine urine dipstick confirms glycosuria.
Initial therapy with this patient should include which of the following?
lifestyle changes and metformin
Question 5
Edited: Jul 24, 2018
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A 7-year-old boy with type 1 diabetes mellitus (T1DM) presents for health
maintenance, having been diagnosed with diabetes 6 months earlier. He had
received all indicated pediatric immunizations prior to his diagnosis. What
additional immunization is indicated in children with T1DM?
23-valent pneumococcal polysaccharide vaccine (PPSV23)
Question 6
Edited: Feb 6, 2019
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A 12-year-old patient with insulin-dependent diabetes mellitus awakens at 2
am after a horrible dream, and notices he is very thirsty. A check of his plasma
glucose level reveals it is 289 mg/dL. Which of the following is the most likely
explanation for his symptoms?
circadian increase in cortisol, growth hormone, and catecholamines (dawn phenomenon)
Question 7
Edited: Jul 24, 2018
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An 11-year-old boy presents to you for a routine well-child visit. His only
complaint is the recent onset of nocturnal enuresis over the last few weeks.
On physical examination, you note that the patient is obese. He has a family
history of diabetes.
Which of the following laboratory test results would confirm the diagnosis of
diabetes in this patient?
random blood glucose level is 235 mg/dL
Question 8
Edited: Jul 24, 2018
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A full-term neonate who is being exclusively breastfed presents for a well-child
visit. Current recommendations for vitamin D supplementation in neonates
and infants include which of the following?
supplementation with 400 IU of vitamin D
Question 9
Edited: Jul 24, 2018
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A 3-hour-old term neonate is jittery and irritable with mild sinus tachycardia of
172 beats/minute. A capillary glucose level measured at the bedside is
reported as 15 mg/dL.
The most appropriate immediate care of this neonate would include which of
the following?
confirmatory testing via venous blood sample while administering an intravenous bolus of dextrose 10% in water at 2 mL/kg
Question 10
Edited: Jul 24, 2018
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A 15-year old boy has newly diagnosed type 1 diabetes mellitus (T1DM). His
mother is very interested in "tight control," because she knows this will
decrease the risks of severe complications in this long-term disease.
She asks your advice on the most common severe complications she might
expect over the next year related to T1DM. Which of the following responses
represents the most accurate answer to this mother's question?
The most common and most serious complication of T1DM is severe hypoglycemia. Unrecognized severe hypoglycemia can lead to loss of consciousness, seizures, and death.
Question 11
Edited: Jul 24, 2018
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A female neonate was born after an uneventful vaginal delivery at term. Her
birth weight is measured at 2900 g and her Apgar scores were 8 at 1 minute
and 9 at 5 minutes. The initial physical examination is completely within
normal limits. At 90 minutes of life, the infant becomes jittery, tremulous, mildly
cyanotic, and hypothermic. A capillary glucose level is measured at the
bedside and is 25 mg/dL.
Which of the following represents the most accurate statement with regard to
this infant?
This infant's hypoglycemia is most likely neonatal transient hypoglycemia associated with inadequate substrate or immature enzyme function in otherwise normal neonates.
Question 12
Edited: Jul 24, 2018
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A 12-year-old patient who was previously diagnosed with attentiondeficit/hyperactivity disorder (ADHD) presents with diarrhea. Her weight has
remained the same over the past 12 months since her last visit. Her heart rate
is 115 beats/minute and the remaining vital signs are otherwise normal.
She has a mild tremor in her hands as she gestures and her mother states
there is "something different" about her eyes (see Figure). [Show Less]