A 3-year-old is hospitalized for an ASD repair. The parents plan to leave briefly. The child asks when his parents will return. The nurse's best response is:

Correct Answer: D

Rationale: The correct answer is D) They will be back when your mommy finishes a short errand, just like when you wait for bedtime. Educational Rationale: This response provides the child with a concrete and relatable timeframe, linking the parents' return to a familiar routine (waiting for bedtime). It offers the child a sense of security and understanding, helping to reduce anxiety during their parents' absence. By connecting the waiting period to a known event, the child can better grasp the concept of time and feel reassured about their parents' return. Why Others are Wrong: A) They will be back after your nap: This answer does not provide a specific timeframe and may cause confusion for the child as nap times vary. B) They will be back at 6:00 p.m.: This answer gives a specific time that a 3-year-old may not fully comprehend, leading to potential distress if the parents are delayed. C) They will be back later this evening: This response is vague and lacks the concrete connection to a familiar routine present in the correct answer. Educational Context: In pediatric nursing, effective communication with children is crucial to providing holistic care. Using language that is developmentally appropriate and relatable helps build trust and rapport with young patients. By offering explanations that connect to their daily experiences, nurses can support children's emotional well-being and foster a sense of security during stressful situations like parental separation in a hospital setting.

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.

Correct Answer: B

Rationale: The correct answer is B) mothers. Child sexual abuse is more commonly perpetrated by males, including fathers, family friends, and teachers. This is due to societal power dynamics and historical trends in reported cases. Fathers and family friends, as male figures in a child's life, may have easier access and influence over the child. Teachers, being in positions of authority, can also exploit their power. However, mothers are less frequently involved in perpetrating child sexual abuse due to various factors such as protective instincts, societal roles, and historical gender norms. In an educational context, it is crucial for healthcare providers and educators to understand the patterns and characteristics of child sexual abuse perpetrators to effectively identify and prevent such cases. By recognizing common perpetrators, professionals can develop targeted intervention strategies, educate families on prevention, and provide support to victims. Additionally, raising awareness about the prevalence and dynamics of child sexual abuse can help reduce stigma and encourage reporting and early intervention.