A 2-month-old premature infant born at 30 weeks gestation is scheduled for an inguinal hernia repair. Which of the following preoperative findings would BEST predict an increased risk of postoperative apnea?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Hemoglobin 7 gm/dL. A low hemoglobin level indicates anemia, which can lead to decreased oxygen-carrying capacity in the blood. In premature infants, who already have underdeveloped respiratory and hematologic systems, this can increase the risk of postoperative apnea. Option B) Glucose 61 mg/dL, while low, is not directly related to the risk of postoperative apnea in this context. Option C) Room air SpO2 92% is slightly lower than the normal range but not significantly concerning for predicting postoperative apnea. Option D) N/A does not provide any relevant information. Educationally, this question highlights the importance of considering the unique physiological vulnerabilities of premature infants when planning surgical interventions. It underscores the need for healthcare providers to assess and address potential risk factors to optimize outcomes for this vulnerable population. Understanding the impact of anemia on oxygen delivery can help guide clinical decision-making and improve patient safety in pediatric surgical settings.

Correct Answer: B

Rationale: In this scenario, the correct response is option B: "The varicella vaccine is not usually administered before 1 year of age." This answer is correct because the Centers for Disease Control and Prevention (CDC) recommends the first dose of the varicella (chickenpox) vaccine to be given at 12-15 months of age. This recommendation is based on the child's immune system development and the optimal age for vaccine effectiveness. Option A is incorrect because vaccinated children are unlikely to develop a mild case of chickenpox as the vaccine is designed to provide immunity against the varicella virus. Option C is incorrect as the timing of the vaccine administration should follow the recommended schedule and not be contingent on a doctor's examination at that specific visit. Option D is also incorrect because while a second dose or booster of the varicella vaccine is recommended at 4-6 years of age, not specifically at 18 months. From an educational perspective, it is important for nurses to have a solid understanding of the recommended vaccination schedules for children to provide accurate information to parents. By adhering to evidence-based guidelines, healthcare professionals can ensure the best protection for children against vaccine-preventable diseases. This question highlights the significance of following age-appropriate vaccination protocols to optimize the effectiveness of immunizations in pediatric populations.

Correct Answer: C

Rationale: In a child with glomerulonephritis, the finding that requires immediate attention is option C: Severe headache and photophobia. This is indicative of potential hypertensive encephalopathy, a serious complication of hypertension in glomerulonephritis, which can lead to seizures, altered mental status, and even stroke. Immediate medical intervention is crucial to prevent further neurological damage. Option A is incorrect as while a high blood pressure of 170/90 is concerning, it does not pose an immediate threat to life like hypertensive encephalopathy. Option B, Coca-Cola-colored urine and low urine output, indicates hematuria and proteinuria, which are common in glomerulonephritis but do not require immediate attention unless there are signs of acute kidney injury. Option D, refusal to eat with poor appetite, is a common symptom in children with glomerulonephritis due to fatigue and malaise but does not signify an acute complication. Educationally, understanding the urgency of certain signs and symptoms in pediatric patients with glomerulonephritis is crucial for nurses and healthcare providers to prioritize interventions and prevent serious complications. It highlights the importance of prompt assessment and appropriate management in pediatric nephrology to ensure optimal outcomes for these vulnerable patients.

Correct Answer: B

Rationale: In prenatal screening for neural tube defects, elevated alpha-fetoprotein (AFP) levels are often detected. AFP is produced by the fetal liver and yolk sac, and elevated levels can indicate a neural tube defect like spina bifida or anencephaly. This screening is crucial for early detection and intervention to prevent potential complications for the fetus. Option A, human chorionic gonadotropin (hCG), is a hormone produced during pregnancy but is not specifically associated with neural tube defects. Estriol (Option C) is a hormone produced by the placenta and fetal liver, used in assessing fetal well-being but not specifically indicative of neural tube defects. Option D, inhibin, is a hormone produced by the ovaries and placenta and is not used in prenatal screening for neural tube defects. Educationally, understanding the rationale behind prenatal screening tests is vital for nursing students and healthcare professionals working in maternal and pediatric care. Recognizing the significance of specific markers like AFP in detecting fetal anomalies empowers healthcare providers to offer informed care and support to pregnant women and their babies. This knowledge contributes to improved prenatal care and outcomes for both mother and child.

Correct Answer: A

Rationale: The correct answer is A) appetite suppression. Stimulant medications, such as those used to treat attention-deficit/hyperactivity disorder (ADHD), commonly cause side effects related to their stimulant properties. Appetite suppression is a well-known side effect of stimulant medications because they can decrease feelings of hunger and lead to weight loss in some individuals. This side effect is important to monitor in pediatric patients to ensure they are maintaining adequate nutrition for growth and development. Option B) gastrointestinal tract symptoms is incorrect because stimulant medications typically do not cause gastrointestinal issues. In fact, these medications are more likely to affect appetite and weight rather than causing direct gastrointestinal symptoms. Option C) sedation is also incorrect as stimulant medications are known for their stimulating effects on the central nervous system, which typically result in increased wakefulness and alertness rather than sedation. Option D) hepatitis is unrelated to the side effects of stimulant medications. Hepatitis is inflammation of the liver usually caused by a viral infection, toxins, or autoimmune conditions, and is not a common side effect of stimulant medications. In the context of maternity and pediatric nursing, understanding the common side effects of medications used in children is crucial for safe and effective care. Educators should emphasize the importance of monitoring for side effects, educating parents and caregivers, and collaborating with healthcare providers to ensure optimal outcomes for pediatric patients receiving stimulant medications.