An 11-year-old child has been brought to the emergency room ...

[EAugust]

An 11-year-old child has been brought to the emergency room because the mother has noted petechiae on his elbows. When the nurse assesses the child, she notes that the boy has purpura on his legs. What action should be taken?
 
  1. Notify the doctor of the medical emergency.
   2. Assess if the child has had hematemesis.
   3. An abuse investigation should be discussed with a social worker.
   4. All of the above would be correct actions.

Question 2

A 15-year-old, sexually active teenage girl comes to the outpatient clinic because she did not have her period this month. Upon assessment, the girl is not pregnant. The nurse says that irregular periods:
 
  1. Usually occur because of pregnancy.
   2. Can occur for 1 to 2 years after your first menses.
   3. Occur because of low stress situations.
   4. Are normal and should not be of concern.

[Chou]

Answer to Question 1

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1. This is not a medical emergency, but should be assessed.
2. The signs are consistent with hematemesis.
3. Because of where the marks are on the child's body, further assessment is needed before notifying a social worker.
4. The signs are consistent with hematemesis.

Answer to Question 2

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1. Periods do not occur if the patient is pregnant.
2. Irregular periods are common for the first two years after a girl starts her menstrual cycle.
3. Irregular periods can occur because of high stress situations, not low stress.
4. Irregular periods are not normal, and the patient should be evaluated if they continue after the first two years after she starts her menstrual cycle.