A 15-month-old male child with failure to thrive, diarrhea, and fatty stool. Of the following, the MOST common possible cause of his illness is

Correct Answer: A

Rationale: In this scenario, the most common possible cause of the 15-month-old child's symptoms (failure to thrive, diarrhea, and fatty stool) is malabsorption (Option A). Malabsorption refers to the inability of the digestive system to properly absorb nutrients from food, leading to nutritional deficiencies and symptoms like those described. Option A is the correct answer because the symptoms of failure to thrive, diarrhea, and fatty stool are classic signs of malabsorption in children. Malabsorption can be due to various conditions such as cystic fibrosis, celiac disease, or short bowel syndrome, which can affect nutrient absorption and result in poor growth and gastrointestinal issues. Option B (intestinal parasites) is less likely in this case as the symptoms described are more indicative of a chronic condition like malabsorption rather than an acute parasitic infection. While intestinal parasites can cause diarrhea and malabsorption, they are not as common a cause in this context. Option C (milk protein intolerance) could present with similar symptoms, but it would typically lead to more immediate gastrointestinal reactions like vomiting and abdominal pain rather than chronic failure to thrive and fatty stool. Option D (pancreatic insufficiency) could also lead to malabsorption due to inadequate enzyme production for digestion, but it is less common in young children and typically presents with other symptoms like steatorrhea (fatty stools) and weight loss. Educationally, understanding the differential diagnosis of failure to thrive in children is crucial for pediatric nurses. Recognizing the signs and symptoms of malabsorption and knowing the common causes can aid in timely diagnosis and appropriate management to improve the child's nutritional status and overall health.

Correct Answer: C

Rationale: The correct answer is C) A systematic method to assess the newborn at birth. The Apgar score is a quick assessment tool used by healthcare providers to evaluate a newborn's physical condition immediately after birth. It helps determine if the baby needs any immediate medical attention or intervention. The score is based on five criteria: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each criterion is scored from 0 to 2, and the total score ranges from 0 to 10. Option A) A predictor of future development quotients is incorrect because the Apgar score does not predict a child's future development. It is solely a snapshot of the newborn's immediate condition at birth. Option B) A predictor of cerebral palsy is incorrect because the Apgar score does not predict specific long-term outcomes like cerebral palsy. It is a tool for immediate assessment and intervention, not for long-term prognostication. Option D) A predictor of neonatal survival is incorrect because while a low Apgar score may indicate a need for medical intervention to support the newborn's survival, it is not a definitive predictor of survival outcomes. In an educational context, understanding the Apgar score is crucial for pediatric nurses as it guides their initial assessment and care of newborns. It helps them prioritize interventions and communicate effectively with other members of the healthcare team. By mastering the Apgar scoring system, nurses can contribute to improving outcomes for newborns in the critical moments following birth.

Correct Answer: B

Rationale: In this scenario, the most likely problem the patient is experiencing at one month of age with significant pallor, tachycardia, and a new heart murmur is ductal dependent congenital heart disease (Option B). Ductal dependent congenital heart disease refers to a group of heart defects where blood flow to the body is dependent on the patent ductus arteriosus (PDA) remaining open. In this case, the closure of the ductus arteriosus after birth could lead to decreased blood flow to the body, causing symptoms like pallor, tachycardia, and a heart murmur. Late-onset neonatal sepsis (Option A) is less likely in this case because the symptoms described are more indicative of a cardiac issue rather than an infectious process. Hemolysis (Option C) would typically present with jaundice and anemia, which are not prominent in this case. Myocarditis (Option D) is less likely given the absence of symptoms like fever, chest pain, or respiratory distress typically associated with this condition. Educationally, understanding the pathophysiology of ductal dependent congenital heart disease is crucial for pediatric nurses as early detection and intervention are vital in managing such cases. Recognizing the clinical manifestations and differentiating them from other conditions is essential for providing timely and appropriate care to these vulnerable patients.

Correct Answer: C

Rationale: In pediatric nursing, understanding the prevalence of mental health issues among children is crucial for providing holistic care. The correct answer is C) 30%. This percentage reflects the significant impact of mental illnesses on children at some point in their lives. Option A) 10% is too low and underestimates the prevalence of mental health issues among children. Children are vulnerable to a wide range of mental health challenges, making this percentage unrealistic. Option B) 20% is also lower than the actual prevalence rate. Research and clinical data consistently show that a larger proportion of children experience mental health concerns, emphasizing the need for early identification and intervention. Option D) 40% is too high and exaggerates the prevalence of mental illnesses among children. While mental health issues are common, 40% would indicate a crisis-level situation that is not supported by current epidemiological data. Educationally, grasping the true prevalence of mental health issues in pediatric patients informs nursing practice, assessment, and intervention strategies. By recognizing the likelihood of encountering such challenges in clinical settings, nurses can advocate for appropriate resources, support systems, and evidence-based interventions to promote the mental well-being of children.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Separation Anxiety. It is important to understand the developmental stages and common behaviors of children at different ages to provide appropriate care in pediatric nursing. A 7-year-old child expressing fear of being injured by a car is exhibiting separation anxiety, which is a normal part of development at this age. Children around this age often start to understand the concept of danger and harm, and separation anxiety can manifest as fear of being separated from their caregivers or fear of harm coming to themselves or their loved ones. Option A) Phobia typically involves an irrational, persistent fear of a specific object or situation, which is not the case in this scenario. Option B) School Refusal is characterized by a child's refusal to attend school due to anxiety or fear related to school settings, which is not directly related to the fear of being injured by a car. Option D) Generalized Anxiety Disorder involves excessive worry and anxiety about a variety of events or activities, which is not specific to the fear described in the question. Understanding the nuances of childhood fears and anxieties is crucial for pediatric nurses to provide effective care and support to young patients. By recognizing age-appropriate behaviors and responses, healthcare providers can better address children's concerns and promote their emotional well-being.