A 3-year-old boy is hospitalized after falling down the stairs. His mother cries, 'This is all my fault.' Which is the nurse's best response?

Correct Answer: B

Rationale: The correct answer is B) Falls are one of the most common injuries in this age group. This response validates the mother's feelings while also providing information to help her understand that accidents like this are common in toddlers. It reassures her that she is not alone in experiencing such incidents with her child. Option A is incorrect because it dismisses the mother's feelings rather than acknowledging them and providing support. Option C is not the best response in this situation as it focuses on prevention rather than addressing the mother's current emotional state. Option D is also not appropriate as it does not address the mother's feelings of guilt and could come across as insensitive. In an educational context, it is crucial for nurses to demonstrate empathy and understanding when communicating with patients and their families. Acknowledging feelings of guilt or self-blame is essential in building trust and rapport with families in stressful situations. Providing education and reassurance can help alleviate parental anxiety and promote a positive caregiver-child relationship.

Correct Answer: C

Rationale: In this scenario, the correct immediate action for the nurse is option C: Remove the infant from the mother, place the infant in the crib for assessment, obtain oxygen saturation, and administer blow-by oxygen immediately. This option is correct because the infant is displaying signs of respiratory distress, which require prompt intervention to ensure adequate oxygenation and prevent further complications. Option A (Inform the physician) is incorrect as it delays immediate action and could result in a critical situation worsening. Option B (Have the mother stop feeding and observe) is also incorrect as it does not address the urgency of the situation and could lead to a delay in providing necessary interventions. Option D (Continue feeding while monitoring) is potentially harmful as the infant is already displaying signs of respiratory distress, and feeding should be stopped immediately to focus on assessing and managing the respiratory issue. In an educational context, this question highlights the importance of recognizing and responding to signs of respiratory distress in infants. Nurses working in pediatric settings must be able to quickly assess and intervene in situations where an infant's health and well-being are at risk. Understanding respiratory distress symptoms and knowing the appropriate actions to take can be critical in saving a child's life.

Correct Answer: D

Rationale: In pediatric practice, it is crucial to understand normal child development, including sexual behavior. The correct answer, D) imitating intercourse or other adult sexual behaviors, is highly unusual for a 5-year-old. At this age, children may begin to explore their bodies and have a basic understanding of gender differences, but imitating adult sexual behaviors is beyond their cognitive and emotional capabilities. Option A) touching his genitals in public and B) showing his genitals to others are more common in young children as they discover their bodies and may not fully understand social norms regarding privacy. Option C) undressing in public can also be seen in young children due to their curiosity and lack of awareness of societal expectations. Educationally, it is important to reassure parents about what behaviors are developmentally appropriate and when to be concerned. By understanding these distinctions, healthcare providers can offer guidance on healthy sexual development and identify potential signs of abuse or developmental issues. This knowledge equips providers to support families in promoting a child's overall well-being.

Correct Answer: B

Rationale: The correct answer is B) splenic lymphoma. Hepatitis C virus infection is associated with an increased risk of developing non-Hodgkin lymphoma, particularly splenic lymphoma. This is due to the chronic inflammatory state caused by the virus, which can lead to the development of lymphoproliferative disorders. Option A) hepatoblastoma is a rare liver cancer that primarily affects children and is not directly linked to hepatitis C virus infection. Option C) Hodgkin lymphoma is a different type of lymphoma compared to non-Hodgkin lymphoma, which is the one associated with hepatitis C virus infection. Option D) nasopharyngeal carcinoma is not directly linked to hepatitis C virus infection. It is more commonly associated with other factors such as Epstein-Barr virus infection and environmental factors. In an educational context, understanding the relationship between viral infections like hepatitis C and their potential impact on malignancy is crucial for healthcare providers, especially in pediatrics. This knowledge can guide appropriate screening, management, and treatment strategies for patients with hepatitis C infection to prevent or detect associated malignancies early.

Correct Answer: D

Rationale: In pediatric oncology, understanding the potential late neurologic sequelae post craniospinal irradiation is crucial for nurse practitioners. The correct answer, D) second malignancy, is the least common late neurologic sequelae in a 9-year-old child with medulloblastoma. This is due to the risk of radiation-induced secondary cancers, although it is a less common outcome compared to other sequelae. Option A) microcephaly is not typically associated with late neurologic sequelae post craniospinal irradiation. Option B) learning disabilities and C) cognitive impairment are more common sequelae in pediatric patients due to the impact of radiation on the developing brain. Educationally, this question highlights the importance of understanding the various potential long-term effects of craniospinal irradiation in pediatric patients with medulloblastoma. Nurse practitioners need to be aware of these possible outcomes to provide comprehensive care, educate families, and monitor for signs and symptoms of late effects throughout the child's survivorship journey.