A 3-month-old baby girl admitted to pediatric intensive care unit with severe head injury (evident by CT scan), the history given by parents was trivial and not informative. You suspected child abuse. Of the following, the MOST helpful study to support your suspicion is

Correct Answer: D

Rationale: In this scenario, the most helpful study to support the suspicion of child abuse in a 3-month-old baby with a severe head injury is a radionuclide bone scan (Option D). This is because a radionuclide bone scan can help identify occult fractures that may not be evident on plain X-rays. Option A, infantogram, is not the most appropriate choice as it provides a general overview of the entire body but may miss subtle fractures. Option B, X-rays of the spine, is not the most helpful study in this context as the primary concern is the head injury. Option C, X-rays of the skull, may show obvious fractures but can miss subtle or occult injuries that a radionuclide bone scan can reveal. Educationally, understanding the importance of selecting the most appropriate diagnostic study in cases of suspected child abuse is crucial for healthcare providers working with pediatric patients. Recognizing the limitations of certain imaging modalities and knowing when to utilize more sensitive tests like a radionuclide bone scan can aid in the accurate diagnosis and appropriate management of cases involving child abuse.

Correct Answer: C

Rationale: In this case, the correct answer is C) Renal ultrasonography. The presence of a ventricular septal defect, cleft lip and palate, and imperforate anus suggests a genetic syndrome or chromosomal abnormality, which is why option A) A karyotype analysis is appropriate. The TORCH titer (option B) is important to rule out infections that could have contributed to the multiple congenital anomalies. Ultrasonography of the brain (option D) can help detect any brain abnormalities that may be present. Renal ultrasonography (option C) is not directly indicated based on the given conditions. It would be more relevant to focus on imaging studies that assess the specific anomalies observed in the newborn in this scenario. Understanding the reasoning behind each test is crucial in pediatric nursing as it helps in making informed clinical decisions and providing appropriate care for patients with complex medical conditions.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Stage I hypoxic ischemic encephalopathy. A newborn with Apgar scores of 7 and 9 at 1 and 5 minutes, respectively, exhibiting hyperalertness, hyperactive deep tendon reflexes, and mydriasis is showing signs of central nervous system irritability, which are characteristic of Stage I HIE. This stage is marked by transient neurological signs due to cerebral irritability without structural damage. Option B) Stage II HIE involves more severe symptoms like seizures, coma, and abnormal neuroimaging findings, which are not present in this case. Option C) Stage III HIE includes severe symptoms such as stupor, coma, and significant brain injury, which are not evident here. Option D) Kernicterus is a condition caused by severe jaundice leading to bilirubin deposition in the brain, presenting with specific symptoms like choreoathetoid cerebral palsy and hearing loss, which are not described in the case. Educationally, understanding the progression and manifestations of hypoxic ischemic encephalopathy in neonates is crucial for pediatric nurses and healthcare providers to provide appropriate care and interventions. Recognizing the different stages of HIE helps in early identification, management, and prevention of long-term neurological sequelae in newborns.

Correct Answer: D

Rationale: In this question regarding late complications of Rhesus sensitization hyperbilirubinemia and its treatment, option D, "Graft-versus-host disease," is the correct answer. Rationale: - Graft-versus-host disease is not a late complication of Rhesus sensitization hyperbilirubinemia. It is a condition where the immune cells from a donor graft attack the recipient's tissues. - This condition is not directly related to the pathophysiology or treatment of hyperbilirubinemia in newborns. - It is important to understand that the other options, A) Transient aregenerative anemia, B) Direct-reacting hyperbilirubinemia, and C) Hypoglycemia, are all potential complications associated with hyperbilirubinemia in newborns. - Transient aregenerative anemia can occur due to the breakdown of red blood cells, direct-reacting hyperbilirubinemia is a form of jaundice resulting from elevated bilirubin levels, and hypoglycemia can be a consequence of the metabolic stress caused by hyperbilirubinemia treatment. Educational Context: Understanding the late complications of Rhesus sensitization hyperbilirubinemia is crucial for healthcare professionals, especially those working with newborns. By recognizing these complications and their treatments, healthcare providers can intervene promptly to prevent adverse outcomes for newborns affected by hyperbilirubinemia. This knowledge is essential for nurses, doctors, and other healthcare professionals caring for infants at risk of developing hyperbilirubinemia-related complications.

Correct Answer: D

Rationale: In this question, the correct answer is D) Risperidone - Tricyclic Antidepressants. Risperidone is an atypical antipsychotic medication, not a tricyclic antidepressant. A) Methylphenidate is correctly matched with Stimulant as it is commonly used to treat ADHD by increasing dopamine and norepinephrine levels in the brain. B) Atomoxetine is correctly matched with Serotonin-Norepinephrine Reuptake Inhibitor as it is a selective norepinephrine reuptake inhibitor used to treat ADHD. C) Fluoxetine is correctly matched with Selective Serotonin Reuptake Inhibitor as it is a common antidepressant that works by increasing serotonin levels in the brain. Understanding the pharmacological classification of medications is crucial for safe and effective pediatric nursing practice. It is important for pediatric nurses to be able to differentiate between different classes of medications to ensure appropriate administration and monitoring for pediatric patients.