A 2-year-old admitted 2 days ago is crying and inconsolable. The nurse tells the parents this is the:

Correct Answer: D

Rationale: In pediatric nursing, understanding the stages of separation anxiety in children is crucial for providing effective care. In this scenario, the correct answer is D) Protest stage of separation anxiety. During the protest stage, children display distress, crying, and actively seeking contact with their primary caregiver, which is evident in the 2-year-old's behavior of crying and being inconsolable. This stage reflects the child's resistance to separation and a strong attachment to their caregiver. Option A) Detachment phase is incorrect because it refers to a stage where the child appears calm but is actually withdrawing emotionally. Option B) Despair stage involves feelings of hopelessness and sadness after realizing the caregiver is not present, which does not align with the child's current behavior. Option C) Bargaining stage is not relevant to separation anxiety in children. Educationally, understanding these stages helps nurses provide holistic care by anticipating and addressing the emotional needs of pediatric patients during hospitalizations or separations from their families. It also enables nurses to support parents in coping with their child's reactions and promotes a therapeutic environment for the child's emotional well-being.

Correct Answer: C

Rationale: In this scenario, the best response to the parent's question about choosing peritoneal dialysis over hemodialysis for their child with acute renal failure (ARF) is option C: "Peritoneal dialysis removes fluid at a slower, more controlled rate, which minimizes complications." The correct answer is right because peritoneal dialysis allows for a gradual removal of fluid and waste products from the body, which is particularly beneficial in pediatric patients with ARF. This slower and more controlled rate helps prevent rapid shifts in electrolytes and fluid balance, reducing the risk of complications such as hypotension or electrolyte imbalances. Option A is incorrect because hemodialysis can indeed be used in pediatrics, although peritoneal dialysis is often preferred in certain situations. Option B is incorrect as peritoneal dialysis, like any medical procedure, can have complications such as infection, catheter-related issues, or fluid imbalances. Option D is incorrect because hemodialysis is generally considered more efficient than peritoneal dialysis in terms of toxin removal and fluid management, but the choice between the two modalities depends on various factors including the patient's condition, age, and clinical needs. In an educational context, it is important for healthcare providers to understand the rationale behind choosing specific dialysis modalities for pediatric patients with ARF. By selecting the most appropriate method based on individual patient factors, healthcare teams can optimize outcomes and minimize risks associated with renal replacement therapy in this vulnerable population.

Correct Answer: B

Rationale: In chronic renal failure (CRF), the correct answer is B) Calcium and phosphorus are drawn from the bones due to hypocalcemia. In CRF, the kidneys are unable to regulate electrolyte levels effectively, leading to imbalances. Hypocalcemia, or low calcium levels, is common in CRF because the kidneys are unable to activate vitamin D properly, resulting in decreased absorption of calcium from the intestines. To maintain blood calcium levels, the body starts to leach calcium and phosphorus from the bones, leading to bone demineralization. Option A is incorrect because in CRF, there is actually an increase in serum phosphorus levels due to the kidneys' inability to excrete phosphorus efficiently. This leads to hyperphosphatemia rather than decreased levels. Option C is incorrect because structural changes in the bones can occur due to increased parathyroid hormone levels in response to low calcium levels, leading to bone resorption rather than calcium remaining in the bones. Option D is incorrect because poor nutrition can contribute to electrolyte imbalances but is not the primary cause in CRF, where the imbalance is mainly due to kidney dysfunction. In an educational context, understanding the electrolyte imbalances in CRF is crucial for pediatric nurses caring for children with this condition. By grasping the pathophysiology behind these imbalances, nurses can provide appropriate interventions to manage electrolyte levels effectively and prevent complications such as bone diseases. It is essential for nurses to monitor electrolyte levels closely, educate patients and families on dietary modifications, and collaborate with the healthcare team to optimize the child's care.

Correct Answer: A

Rationale: In the early stages of acute hepatitis, manifestations typically include nausea, vomiting, and generalized malaise, making option A the correct answer. This is because hepatitis causes inflammation of the liver, leading to these non-specific symptoms in the initial phase of the illness. Option B (Nausea, vomiting, and left-upper quadrant pain) is incorrect because left-upper quadrant pain is not a typical early symptom of acute hepatitis. The liver is located in the right-upper quadrant, so pain is more likely to be felt in that region. Option C (Malaise and jaundice only) is incorrect because jaundice usually appears later in the course of acute hepatitis once the liver is significantly affected. Malaise alone is also a non-specific symptom that can be present in various conditions. Option D (Jaundice only) is incorrect because jaundice is not typically the only symptom seen in the early stages of acute hepatitis. It usually develops as the disease progresses and liver function is further compromised. In an educational context, understanding the progression of symptoms in acute hepatitis is crucial for nurses caring for pediatric patients. Recognizing the early signs can lead to prompt diagnosis and intervention, improving outcomes for children with this condition. Nurses must be knowledgeable about the typical manifestations of hepatitis to provide appropriate care and support to pediatric patients and their families.

Correct Answer: B

Rationale: The correct answer is B) supracondylar region of the femur. Osteopenia is a common complication following spinal cord injury (SCI) due to decreased weight-bearing activity and hormonal changes, leading to bone mineral density loss. The supracondylar region of the femur is the most common site for fractures in individuals with osteopenia due to its susceptibility to fractures under conditions of decreased bone density and increased stress. Option A) distal tibia is less likely as the most common site for fractures in osteopenia following SCI compared to the femur. Option C) lumbosacral spine is less likely as it is more commonly associated with vertebral compression fractures in conditions like osteoporosis. Option D) proximal humerus is less likely as it is not as commonly affected by osteopenia-related fractures in SCI patients compared to weight-bearing bones like the femur. Educationally, understanding the specific sites of fractures in osteopenia post-SCI is crucial for nurses caring for these patients. Recognizing the common sites of fractures can aid in preventive measures, early detection, and appropriate management to prevent further complications and promote optimal patient outcomes.