NURS 629 Exam 4 Latest Version 2023 2024 Questions and Correct Solutions Guaranteed 100% Pass Rate Absent seizures - Correct Answervery quick, <10 seconds- often missed generalized onset involving both sides of the brain at the same time most common type stops all activity then patient stares off eyes may roll up eyelids flutter
Atonic seizures - Correct Answermuscles suddenly become limp eyelids may droop head may drop forward fall risk typically lasts <15 seconds
Atypical absent seizures - Correct Answerstarts with patient staring off, change muscle tone and movement blinking repeatedly smacking lips or chewing movements rubbing fingers together or making other hand motions lasts longer than absent >20 seconds
Blood glucose goals - Correct AnswerAges <= 6 yo keep to 100-180 and may need to give insulin after meals; HBA1c 8.5% Ages 7-12 tighten control to 90-180 before meals; HBA1c 8%
Adolescents tighten control to 70-150: HBA1c 7.5%
per PP and pg 1856 of AAP book **other study guide states ideal glucose level for 4 yo is 90-130
Characterization of Type 1 DM - Correct Answerchild/adolescent lean habitus no acanthosis 5% family hx most common in Caucasians DKA is common/rapid lifelong insulin dependence common autoimmunity
Characterization of type 2 DM - Correct Answeradolescent or older heavy habitus acanthosis positive family hx (75-100%) likely non-caucasian 1 / 2
DKA is uncommon/insiduous insulin dependence is episodic autoimmunity uncommon
Clinical findings for Osgood-Sclatter disease - Correct Answerpain, swelling, tenderness at tibial tuberosity knee pain that worsens with activity tightness of the surrounding muscles, especially quads pain varies from mild with activity to nearly constant and debilitating
Criteria to dx diabetes - Correct Answersymptoms of diabetes plus random plasma glucose >= 200 mg/dl OR fasting plasma glucose >=126 mg/dl OR
- hr plasma glucose >= 200 ml/dl during OGTT (1.75 gm/kg or max 75 gm glucose in
water)
Diagnostic for depression - Correct AnswerPHQ-9 can be used for ages 11 and up -insomnia or hypersomnia, just like our adults; psychomotor agitation or retardation observable by others; fatigue or loss of energy; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate or indecisiveness; and recurrent thoughts of death is another characteristic -criteria to meet the diagnosis of depression is 5 or more symptoms, most of the day nearly every day, have been present during the same 2-week period
Diagnostic for SCFE - Correct Answerx-ray
Diagnostic for scoliosis - Correct Answerupright posteroanterior and lateral view that include the cervical spin and pelvis pg. 2670 AAP book
Diagnostic testing for appendicitis - Correct AnswerCBC w/ diff- look for shift to left, *elevated WBCs usually 10-20, neutrophils, elevated bands UA CT w/ contrast- highest accuracy may use US/MRI **surgery referral, emergent
Diagnostic testing for GERD - Correct AnswerCBC w/ diff to r/o anemia and infection upper GI series
Diagnostic testing for pyloric stenosis - Correct AnswerUS, upper GI series which can show a "string sign" which is a fine elongated pyloric canal "olive mass" palpable in epigastric area to right of midline Treatment is surgery (pyloromyotomy)
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