NCLEX Pratice Test 4

Osgood-Schlatter disease is a condition that commonly affects adolescents who are involved in activities that involve frequent jumping and running, such as sports. It is characterized by pain and swelling in the area below the kneecap, known as the inferior aspect of the knee. The condition is not caused by a specific sport or activity, and surgical intervention is usually not required. Therefore, the correct statement is that the student experiences pain in the inferior aspect of the knee.

The nurse is most likely conducting an assessment for scoliosis. Bending forward at the waist with arms hanging freely allows the nurse to observe the curvature of the spine. This position is commonly used to screen for scoliosis, a condition characterized by an abnormal sideways curvature of the spine. By observing the alignment of the spine in this position, the nurse can assess for any signs of scoliosis.

The nurse suspects that the child's symptoms, including swelling of the lower affected leg and refusal to walk, may be caused by a possible fracture of the tibia. This is the most likely explanation given the symptoms described.

Patients with peripheral vascular disease have decreased blood flow to the extremities, which can lead to complications such as poor wound healing and increased risk of infection. Crossing the legs can further restrict blood flow and exacerbate these issues. Therefore, it is important for patients with peripheral vascular disease to avoid crossing their legs. The other options mentioned in the question are incorrect and may even be harmful for patients with this condition.

An abusing parent is least likely to exhibit self-blame for the injury to the child. Abusers often lack empathy and tend to blame others or external factors for their actions. They may deny responsibility or minimize the harm caused to the child. This behavior is a defense mechanism to avoid feelings of guilt or shame. Therefore, it is unlikely for an abusing parent to take self-blame for the injury to the child.

A family history of heart disease is a hereditary risk factor for developing atherosclerosis. This means that if a person has close relatives, such as parents or siblings, who have had heart disease, they are at a higher risk for developing atherosclerosis themselves. This is because certain genes and genetic factors can increase the likelihood of developing the condition. Overweight, smoking, and age are not hereditary risk factors, but they can contribute to the development of atherosclerosis in other ways.

The patient's symptoms of burning and tingling in the hands and feet, as well as intolerance to touch, are consistent with nerve damage. Inadequate tissue perfusion, which refers to a decreased blood flow to the affected areas, can lead to nerve damage. When tissues do not receive enough oxygen and nutrients due to poor blood flow, the nerves in those areas can become damaged, resulting in these symptoms. This explanation aligns with the patient's diagnosis of peripheral vascular disease, which is characterized by reduced blood flow to the extremities.

The most likely cause of the patient's symptoms is a pulmonary embolism due to deep vein thrombosis (DVT). This is because the patient is pregnant and has been on complete bed rest, which increases the risk of developing blood clots. The sudden shortness of breath and chest pain are classic symptoms of a pulmonary embolism, which occurs when a blood clot in the leg (DVT) breaks free and travels to the lungs, causing a blockage in the pulmonary arteries. Myocardial infarction, anxiety attack, and congestive heart failure are less likely causes in this scenario.

The most likely explanation for the infant's unusual head position and always facing to one side is torticollis, which is characterized by the shortening of the sternocleidomastoid muscle. This condition causes the head to tilt to one side and can result from a variety of factors such as birth trauma, muscle imbalance, or abnormal positioning in the womb. Treatment for torticollis may include stretching exercises, physical therapy, or in severe cases, surgery.

Before starting parenteral antibiotics, it is important to draw a blood culture to identify the specific bacteria causing the infection. This will help determine the most appropriate antibiotic to use for treatment. The blood culture will also provide information about the severity of the infection and whether it has spread to the bloodstream, which can help guide further management decisions. Therefore, drawing a blood culture is the immediate action that should be done before starting antibiotics in this case.

Acute glomerulonephritis is most commonly caused by a prior infection with group A Streptococcus within the past 10-14 days. This is because the immune response to the infection can cause inflammation and damage to the glomeruli, which are the filtering units of the kidneys. This condition is known as poststreptococcal glomerulonephritis and is characterized by symptoms such as hematuria, proteinuria, and hypertension. Other conditions mentioned in the options, such as congenital conditions, viral infections, and nephrotic syndrome, can also cause glomerulonephritis, but they are not the most common cause.

Hydrocele is a condition where fluid accumulates in the scrotum, causing it to swell. In infants, hydroceles often resolve on their own as the body reabsorbs the fluid. The fact that the scrotum is smaller than at birth indicates that the fluid is indeed being reabsorbed. Therefore, no treatment is necessary, and the physician is likely to recommend monitoring the condition without intervention.

Duchenne's muscular dystrophy is an X-linked recessive disorder, which means that it is caused by a mutation on the X chromosome. Since males have one X and one Y chromosome, if they inherit the mutated X chromosome, they will develop the disease. On the other hand, females have two X chromosomes, so even if they inherit one mutated X chromosome, the other normal X chromosome can compensate for the mutation, making them carriers of the disease. Therefore, daughters have a 50% chance of being carriers and sons have a 50% chance of developing the disease.

A, C and D is correct

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Thrombolytic therapy is a treatment used to dissolve blood clots in the body. However, it can also increase the risk of bleeding, including cerebral hemorrhage, which is bleeding in the brain. This complication occurs because thrombolytic therapy can cause the blood to become too thin, leading to the rupture of blood vessels in the brain and subsequent bleeding. Therefore, cerebral hemorrhage is a significant complication associated with thrombolytic therapy.

Most children with juvenile idiopathic arthritis progress to adult rheumatoid arthritis. This statement is accurate because juvenile idiopathic arthritis is a chronic autoimmune disease that primarily affects children and can continue into adulthood. While some children may experience joint deformities, it is not true that all children with this condition will have poor chances of recovery without joint deformity. Nonsteroidal anti-inflammatory drugs may be used in the treatment of juvenile idiopathic arthritis, but they are not always the first choice. Physical activity is actually encouraged as it can help improve joint mobility and overall well-being in children with this condition.

A young woman is most likely to fit the description of a patient with vasospastic disorder (Raynaud's disease). Raynaud's disease is more common in women, especially young women. It is characterized by episodes of vasospasm in the small arteries of the fingers and toes, leading to coldness, numbness, and stiffness in the affected areas. This condition is often triggered by cold temperatures or emotional stress.

A,B, and C are correct

A, B and D are correct