The nurse urges the mother of a 6 month old to have her child vaccinated with Haemophilus influenzae type B to protect against:

Correct Answer: C

Rationale: Hib vaccine prevents bacterial meningitis (C) caused by Haemophilus influenzae. Hepatitis (A), otitis (B), and encephalitis (D) have different etiologies. Document: 'H. influenza type B… vaccines have decreased… bacterial meningitis.'

Correct Answer: C

Rationale: A 7-year-old with recent parental separation shows school refusal, aggression, social withdrawal, and temper outbursts, suggesting major depressive disorder (Choice C). These symptoms—irritability, anhedonia (avoiding friends), and behavioral changes—align with pediatric depression, often triggered by stressors like divorce. ADHD (Choice A) involves chronic inattention/hyperactivity, not acute onset. Conduct disorder (Choice B) lacks the mood and withdrawal elements. Separation anxiety (Choice D) focuses on clinginess, not aggression or anhedonia. Depression best explains the presentation.

Correct Answer: A

Rationale: Down syndrome has a ~50% incidence of congenital heart defects (e.g., AVSD), making an echocardiogram critical pre-anesthesia to assess cardiac risk (AAP guidelines). EKG is less specific for structural issues. Lateral neck x-ray checks atlantoaxial instability, but cardiac evaluation takes precedence. GI studies (D, E) are irrelevant here.

Correct Answer: A

Rationale: Choice A is false; negative cultures don’t exclude TB in children due to low bacterial yield, relying on clinical diagnosis (AAP). Choices B-E are true.

Correct Answer: D

Rationale: Anti-Ro IgG crosses the placenta, causing neonatal lupus (e.g., heart block) (NIAMS). IgM and IgA (B, C) don’t cross, and E is a misnomer.