A 3-year-old female is hospitalized for a femur fracture. As her nurse, what nursing action would help foster the child's sense of autonomy?

Correct Answer: B

Rationale: In this scenario, the correct action to foster the child's sense of autonomy is option B, allowing the child to have a doll for medical play. This choice promotes the child's independence and control over her healthcare experience. Giving the child a doll for medical play allows her to mimic and process her hospitalization experience, empowering her to express emotions and gain a sense of mastery over the situation. Option A, allowing the child to choose the time for oral antibiotics, may not be developmentally appropriate for a 3-year-old as it involves complex decision-making that may cause anxiety rather than promote autonomy. Option C, allowing the child to self-administer medication, is unsafe due to the child's young age and lack of proper understanding of medication administration. Option D, allowing the child to watch videos, does not directly involve the child in her care or promote her active participation and autonomy. Educationally, understanding the importance of fostering autonomy in pediatric care is crucial for nurses. Children need opportunities to make choices and participate in their care to develop a sense of control and confidence. Providing developmentally appropriate activities like medical play can have a positive impact on a child's hospital experience and overall well-being.

Correct Answer: C

Rationale: In this question about Wilms tumor, option C is correct, while the others are incorrect. Wilms tumor, also known as nephroblastoma, is a type of kidney cancer that primarily affects children. The correct answer, option C, states that it can occur on its own or be associated with congenital anomalies. This is true as Wilms tumor can occur sporadically or in association with certain genetic syndromes like WAGR syndrome. Option A is incorrect because Wilms tumor is not referred to as neuroblastoma. Neuroblastoma is a different type of childhood cancer that arises in immature nerve cells. Option B is incorrect because Wilms tumor is commonly seen in children under the age of 5, not specifically between 2 and 5 years. Option D is also incorrect as Wilms tumor is considered a fast-growing tumor rather than slow-growing, which underscores the importance of early detection and intervention. Educationally, understanding the characteristics and features of pediatric cancers like Wilms tumor is crucial for nurses caring for pediatric patients. Recognizing the signs and symptoms, risk factors, and appropriate nursing interventions for pediatric cancers ensures timely diagnosis and treatment. Nurses play a critical role in supporting children and their families through the challenging journey of cancer diagnosis and treatment, making knowledge of pediatric oncology essential in their practice.

Correct Answer: D

Rationale: Failure to thrive (FTT) is a condition where infants and young children fail to meet expected growth standards due to malnutrition. In this context, the growth parameter that is usually not affected by malnutrition is head circumference (Option D). Head circumference is primarily determined by brain growth, which is a relatively metabolically stable process compared to overall body growth affected by malnutrition. Option A (weight) is commonly affected by malnutrition as it reflects overall body mass and nutritional status. Option B (height) can be impacted by malnutrition as it represents linear growth and skeletal development which can be stunted with inadequate nutrition. Option C (weight for height ratio) is also influenced by malnutrition as it indicates if the child's weight is appropriate for their height, reflecting overall nutritional status. In an educational context, understanding the growth parameters affected by malnutrition is crucial for healthcare professionals, especially in pediatrics. By knowing which growth parameters are more resilient to malnutrition, healthcare providers can better assess and monitor the nutritional status and overall health of children. This knowledge aids in early detection and intervention for children at risk of FTT, ultimately improving their outcomes and quality of life.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the causes of secondary nocturnal enuresis is crucial for providing effective care to children. Secondary nocturnal enuresis refers to the involuntary passage of urine during sleep in a child who previously had established nighttime bladder control. In this scenario, the correct answer is D) psychosocial stressor. Children with secondary nocturnal enuresis may experience psychosocial stressors such as anxiety, emotional disturbances, changes in the family environment, or trauma. These stressors can disrupt the child's normal bladder control mechanisms, leading to bedwetting episodes. Addressing and managing these stressors are essential components of the nursing care plan for a child with secondary nocturnal enuresis. Option A) UTI (urinary tract infection) is not typically associated with secondary nocturnal enuresis unless there are other symptoms present to suggest an infection, such as fever, dysuria, or frequency. Option B) diabetes mellitus and option C) diabetes insipidus are metabolic conditions that may lead to increased urine output but are less likely causes of secondary nocturnal enuresis compared to psychosocial stressors. Educationally, this question highlights the importance of considering psychosocial factors in the assessment and management of pediatric patients with secondary nocturnal enuresis. By understanding the underlying causes, nurses can provide holistic care that addresses both the physical and emotional needs of the child and their family.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) AML M6. Acute Myeloid Leukemia (AML) is the most likely type of leukemia to develop in a 2-year-old child with Down syndrome in the neonatal period. Children with Down syndrome have a higher risk of developing AML compared to other types of leukemia. AML M6 specifically refers to acute erythroleukemia, which is characterized by the presence of both myeloid and erythroid blasts in the bone marrow. Option A, ALL (Acute Lymphoblastic Leukemia), is less likely in this case as Down syndrome is not strongly associated with ALL. Option B, CML (Chronic Myeloid Leukemia), is a chronic leukemia that typically occurs in adults, making it less likely in a 2-year-old child. Option C, AML M1, is a subtype of AML but is less common in children with Down syndrome compared to AML M6. Educationally, understanding the association between Down syndrome and specific types of leukemia is crucial for nursing students caring for pediatric patients. This knowledge helps in early identification, appropriate treatment, and better outcomes for children with Down syndrome who may develop leukemia. It also highlights the importance of personalized care based on both the patient's age and underlying conditions.