The nurse would caution parents that massage should not be considered as an alternative therapy for a child with:

Correct Answer: C

Rationale: Massage risks cervical spine injury in Down syndrome (C) due to instability. Fractures (A), diabetes (B), and eating disorders (D) have no such contraindication. Document: 'Children with Down syndrome… may be injured by massage therapy.'

Correct Answer: D

Rationale: Cyclophosphamide (D), an immunosuppressant, induces diuresis in steroid-resistant nephrotic syndrome. Ibuprofen (A), furosemide (B), and ciprofloxacin (C) don’t address the underlying issue. Document: 'A potent antisuppressant such as Cytoxan can bring about diuresis.'

Correct Answer: A

Rationale: A 14-year-old with type 1 diabetes on an insulin pump has hyperglycemia (20.2 mmol/L) and mild ketosis (1.2 mmol/L), but is otherwise well. A correction bolus of rapid-acting insulin via the pump (Choice A) is the standard approach to correct hyperglycemia, leveraging the pump’s precision and existing functionality. Using a syringe or pen (Choice B) is unnecessary unless pump failure is suspected, which isn’t indicated. Long-acting insulin (Choice C) is inappropriate for acute correction. Exercise and water (Choice D) risk worsening ketosis without insulin. The pump bolus is the safest, most effective option.

Correct Answer: C

Rationale: HEADSS assesses adolescent psychosocial risks: Home, Education, Activities, Drugs, Sex, Suicide/Depression. ‘A’ stands for Activities (Choice C), exploring hobbies, sports, or social engagement to build rapport. Academic achievement (Choice A), Accommodation (Choice B), and Affect (Choice D) aren’t part of HEADSS. Activities is correct.

Correct Answer: C

Rationale: Selective IgA deficiency can trigger anaphylaxis to IgA in blood products; washed erythrocytes remove plasma IgA, preventing reactions (AABB). Other options (A-D) contain IgA and risk reaction.