Deteriorating insulation is found in the ceilings of a local school built in 195Parents and teachers are extremely concerned that it may be asbestos, and they call on you, the local pediatrician, to give advice in an open meeting. What advice would you give?

Correct Answer: C

Rationale: Asbestos should be confirmed by laboratory testing, and if present, a certified engineer should assess the situation to determine the safest course of action.

Correct Answer: C

Rationale: For a child with chronic renal failure, it is important to recommend a diet that is low in phosphorus. In chronic renal failure, the kidneys have difficulty filtering phosphorus from the blood, leading to high levels of phosphorus in the body. High phosphorus levels can contribute to bone problems and other complications in renal failure patients. By recommending a diet low in phosphorus, the nurse can help manage the child's condition and reduce the risk of further complications. It is also important to monitor other electrolyte levels such as calcium, potassium, and sodium, and adjust the diet accordingly to maintain proper balance.

Correct Answer: B

Rationale: The management goal for a child with minimal change nephrotic syndrome is to reduce the excretion of urinary protein. In this condition, there is an abnormal loss of protein in the urine due to damage in the glomeruli of the kidneys. Reducing the excretion of urinary protein helps prevent complications associated with protein loss, such as edema and hypoalbuminemia. While reducing blood pressure may be important in some cases, the primary focus for this specific condition is to address the protein leak in the urine. Increasing the excretion of urinary protein would worsen the condition, and increasing the ability of tissues to retain fluid is not the desired outcome in this context.

Correct Answer: C

Rationale: Dyspnea, or difficulty breathing, may be the first abnormal sign detected in a client with cardiomyopathy. Cardiomyopathy is a disease of the heart muscle, which can lead to impaired heart function. As the heart's ability to pump blood effectively is compromised, the body may not receive an adequate supply of oxygen-rich blood. This can result in symptoms such as dyspnea, especially during physical exertion or when lying down. Ascites (fluid accumulation in the abdomen), chest pain, and heart murmur may also be seen in clients with cardiomyopathy but are not typically the first signs to present. Dyspnea is often a key indicator that should prompt further evaluation and monitoring for cardiac issues.

Correct Answer: A

Rationale: Tetralogy of Fallot is a combination of four structural defects in the heart. These include pulmonic stenosis (narrowing of the pulmonary valve or artery), ventricular septal defect (hole in the wall that separates the two lower chambers of the heart), overriding aorta (aorta positioned directly over the ventricular septal defect), and right ventricular hypertrophy (enlargement of the right ventricle due to increased workload). Therefore, the correct combination of defects that constitute tetralogy of Fallot is pulmonic stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy, which is option A.