A 3-year-old child from a suburban community presents with vomiting, diarrhea, and blurred vision. Physical examination reveals an afebrile child with pinpoint pupils, salivation, and muscular fasciculations. The child's lawn was treated yesterday for insects. Which of the following tests will establish the correct diagnosis?

Correct Answer: C

Rationale: The symptoms suggest organophosphate poisoning, which can be confirmed by measuring plasma cholinesterase levels, as organophosphates inhibit this enzyme.

Correct Answer: C

Rationale: A 6-hour glucose tolerance test would yield the most occlusive diagnostic information about the client's glucose utilization in this case. The elevated blood pressure level of 185 mg/dL two hours after breakfast indicates poor glucose regulation. A glucose tolerance test involves monitoring the client's blood glucose levels over a period of time after ingesting a glucose solution. This test provides a comprehensive assessment of how the body processes glucose, revealing any abnormalities in glucose metabolism beyond fasting levels, such as postprandial (after-meal) glucose spikes and prolonged hyperglycemia. This can help identify conditions like insulin resistance, impaired glucose tolerance, or diabetes, which may not be evident from a fasting blood glucose test alone. Glycosylated hemoglobin (HbA1c) reflects average blood sugar levels over the past 2-3 months and would not provide immediate information about the client's current glucose metabolism. Urine ketones

Correct Answer: B

Rationale: In chronic renal disease, the kidneys are not functioning properly, leading to an accumulation of phosphorus in the body. High levels of phosphorus can be harmful and contribute to bone and mineral disorders. Calcium carbonate is often given with meals to bind phosphorus in the gut and prevent its absorption. By binding with phosphorus, calcium carbonate helps lower the levels of phosphorus in the blood, thereby managing complications associated with chronic renal disease, such as renal osteodystrophy. It is an essential part of the treatment plan for patients with chronic kidney disease to help maintain appropriate phosphorus balance in the body and prevent further complications.

Correct Answer: A

Rationale: Option A, "Your airways are inflamed and spastic," is the correct explanation of asthma. Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, which causes difficulty in breathing, coughing, and wheezing. The inflammation leads to the airways becoming extremely sensitive to various triggers, such as allergens, irritants, or exercise, resulting in spasms that further constrict the air passages. This constriction makes it challenging for air to move in and out of the lungs efficiently, leading to symptoms such as shortness of breath. It is essential for the patient to understand that asthma is primarily an inflammatory condition rather than a structural or infectious problem.

Correct Answer: B

Rationale: The current recommendations for hepatitis B (HBV) vaccine state that the first dose should be administered between ages 12 and 15 months. The vaccine series typically consists of three doses, with the second dose administered 1-2 months after the first dose, and the third dose given at least 8 weeks after the second dose. This schedule is recommended by the Centers for Disease Control and Prevention (CDC) to provide optimal protection against the hepatitis B virus. Starting the vaccine series at 12-15 months ensures that the child's immune system is mature enough to respond effectively to the vaccine and generate lasting immunity.