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 appropriate care. The correct answer is D) Protest stage of separation anxiety. At around 2 years old, children typically exhibit the protest stage when separated from their primary caregivers. This stage is characterized by crying, screaming, and displaying distress to communicate their discomfort. Option A) Detachment phase is incorrect because it refers to a later stage where the child appears calm and may seem to accept the separation. Option B) Despair stage is also incorrect as it follows the protest stage and involves feelings of hopelessness and sadness. Option C) Bargaining stage does not typically apply to separation anxiety in young children. Educationally, understanding these stages helps nurses anticipate and respond effectively to children's emotional needs during hospitalization. By recognizing the protest stage, nurses can offer comfort, support, and age-appropriate explanations to both the child and the parents, fostering a therapeutic environment for the child's emotional well-being.

Correct Answer: C

Rationale: The correct answer is C) Peritoneal dialysis removes fluid at a slower, more controlled rate, which minimizes complications. In pediatric patients with acute renal failure, peritoneal dialysis is often preferred over hemodialysis due to several reasons. Peritoneal dialysis allows for a slower, more gradual removal of fluid and waste products from the body, which is better tolerated by children, especially those who are hemodynamically unstable. This gentle removal of toxins helps prevent rapid shifts in electrolytes and fluid balance, reducing the risk of complications such as hypotension and cardiac instability. Option A is incorrect because hemodialysis is indeed used in pediatric patients when necessary, but peritoneal dialysis is often preferred due to its advantages in this population. Option B is incorrect as peritoneal dialysis, like any medical procedure, can have complications such as infection, catheter-related issues, and metabolic imbalances. Option D is incorrect as hemodialysis is generally considered more efficient in terms of waste product clearance compared to peritoneal dialysis; however, the choice between the two modalities depends on the individual patient's condition and needs. In an educational context, it is important for healthcare providers to understand the rationale behind choosing peritoneal dialysis over hemodialysis in pediatric patients with acute renal failure to provide optimal care and prevent complications. Understanding the differences in dialysis modalities and their implications for pediatric patients' outcomes is crucial for nursing practice in pediatric nephrology.

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 effectively regulate electrolyte balance, leading to increased phosphate levels and decreased calcium levels in the blood. This imbalance triggers the release of parathyroid hormone, which stimulates the breakdown of bone to release calcium and phosphorus into the bloodstream, causing hypocalcemia. Option A is incorrect because in CRF, there is actually an increased serum phosphorus level due to the kidneys' inability to excrete phosphorus efficiently. This leads to decreased serum calcium levels due to the inverse relationship between calcium and phosphorus levels. Option C is incorrect because although there may be structural changes in the bones over time in individuals with CRF, calcium is still drawn from the bones due to the abnormal phosphate and calcium balance, leading to bone demineralization. Option D is incorrect because poor nutrition may exacerbate electrolyte imbalances in CRF, but the primary mechanism of calcium and phosphorus imbalance in CRF is related to the kidney's inability to regulate these electrolytes. Understanding the electrolyte imbalances in CRF is crucial for pediatric nurses as they care for children with this condition. Nurses need to monitor electrolyte levels, educate patients and families on dietary management, and collaborate with the healthcare team to prevent complications associated with electrolyte imbalances in CRF.

Correct Answer: A

Rationale: In the early stages of acute hepatitis, manifestations typically include nonspecific symptoms such as nausea, vomiting, and generalized malaise, which are reflective of the body's systemic response to the inflammation of the liver. Option A, "Nausea, vomiting, and generalized malaise," is the correct answer because it aligns with these expected early symptoms of acute hepatitis. Option B, "Nausea, vomiting, and left-upper quadrant pain," is incorrect because left-upper quadrant pain is not a typical early manifestation of acute hepatitis. The pain associated with hepatitis is usually more generalized or located in the right upper quadrant due to liver inflammation. Option C, "Malaise and jaundice only," is incorrect because jaundice typically appears later in the course of hepatitis as the liver becomes more compromised. Malaise alone is also not specific enough to indicate acute hepatitis without the presence of other symptoms. Option D, "Jaundice only," is incorrect because jaundice usually develops later in the progression of acute hepatitis as liver function becomes more impaired. It is not typically an early symptom. Educationally, understanding the progression of symptoms in acute hepatitis is crucial for early recognition and intervention to prevent complications. By knowing the expected manifestations, healthcare providers can promptly diagnose and manage the condition, improving patient outcomes.

Correct Answer: B

Rationale: The correct answer is B) supracondylar region of the femur. Osteopenia, a condition of low bone density, commonly occurs post-SCI due to decreased weight-bearing activity and hormonal changes. The femur is a weight-bearing bone and is particularly vulnerable to fractures in individuals with osteopenia. Pathologic fractures in this population often occur at the supracondylar region due to the high mechanical stress placed on this area. Option A) distal tibia and Option D) proximal humerus are less common sites for fractures in individuals with osteopenia post-SCI. Fractures in the lumbosacral spine (Option C) are also possible but less common compared to fractures in weight-bearing bones like the femur. In an educational context, understanding the common sites of fractures in individuals with osteopenia post-SCI is crucial for nurses caring for pediatric patients. This knowledge helps in early identification of potential fractures, implementing preventive measures, and providing appropriate care to minimize complications associated with bone health in this population.