A 3-year-old with croup has the following vital signs: HR 90, RR 44, BP 100/52, T 98.8°F. The parents ask if these are normal. The nurse's best response is:

Correct Answer: C

Rationale: The correct response is Option C, "Your son's respiratory rate is elevated; a normal rate for his age is 20-30 breaths per minute." This answer is correct because it addresses the specific vital sign that is abnormal for the child's age group. In pediatric patients, respiratory rate is an important indicator of respiratory distress, and a rate of 44 breaths per minute is above the expected range for a 3-year-old. Option A, stating that the blood pressure is elevated, is incorrect because the blood pressure provided (100/52) falls within the normal range for a 3-year-old child. Option B, suggesting the temperature is elevated, is incorrect as the temperature of 98.8°F is within the normal range for a child and not indicative of fever. Option D, indicating the heart rate is elevated, is incorrect as a heart rate of 90 beats per minute is within the normal range for a 3-year-old child. Educationally, understanding normal vital signs for pediatric patients is crucial for healthcare providers to assess and monitor children effectively. Recognizing deviations from normal ranges helps in identifying potential health issues and providing appropriate interventions. It is important to educate parents on typical vital sign ranges for children to empower them to recognize signs of illness or distress.

Correct Answer: A

Rationale: The correct answer is A) Allow familiar comfort items (e.g., favorite stuffed animal) and a 'sippy' cup (avoid suction items). Rationale: For a 14-month-old child who has undergone cleft palate repair surgery, it is important to provide comfort and familiarity to reduce stress and anxiety. Allowing familiar comfort items like a stuffed animal can help soothe the child and create a sense of security during the recovery period. Using a 'sippy' cup instead of suction items is crucial to prevent disruption to the surgical site and avoid any complications that may arise from suction. Option B) Once liquids are tolerated, encourage a bland diet (e.g., soup, Jell-O, saltine crackers) is incorrect because the focus initially should be on ensuring proper hydration and comfort rather than immediately introducing solid foods. Option C) Administer scheduled pain medication rather than PRN only is not the priority in the immediate post-operative period. Pain management is important, but ensuring the child's comfort and safety through appropriate interventions is more critical initially. Option D) Using a Yankauer suction catheter to decrease aspiration risk is not recommended in this scenario as suction should be avoided in the immediate post-operative period to prevent disruption to the surgical site. Educational Context: Understanding the specific needs and considerations for pediatric patients, especially those who have undergone surgical procedures like cleft palate repair, is essential for healthcare providers. Providing appropriate post-operative care tailored to the child's age, developmental stage, and specific condition is crucial for ensuring optimal recovery outcomes and preventing complications. Prioritizing comfort, safety, and effective communication with the child and their caregivers are key components of pediatric care in such situations.

Correct Answer: D

Rationale: In pediatric practice, the identification of potential signs of sexual abuse is crucial for early intervention and protection of the child. The behavior of hypersexuality should raise suspicion of sexual abuse due to its association with exposure to inappropriate sexual behaviors or experiences beyond the child's developmental stage. Children who exhibit hypersexual behavior may have been exposed to sexual content or actions that are not age-appropriate, indicating possible abuse. Aggressive behavior (option A) can be a response to various stressors and is not specific to sexual abuse. Obsessive-compulsive behavior (option B) is more commonly associated with anxiety disorders or certain developmental conditions rather than sexual abuse. Dissociative behavior (option C) might be present in children who have experienced trauma, including sexual abuse, but it is not specific enough to solely indicate sexual abuse. Educationally, it is important for healthcare providers and educators to be aware of the signs and symptoms of sexual abuse in children to provide appropriate support and referrals. Understanding the nuances of different behaviors and their potential causes can aid in early identification and intervention, ultimately safeguarding the well-being of children who may be at risk.

Correct Answer: D

Rationale: In this case, the correct answer is option D) hepatoblastoma. Hepatoblastoma is a rare pediatric liver cancer that typically occurs in children under the age of 3, with peak incidence around 18 months. While it is a rare malignancy, it is more commonly seen in early childhood compared to the other options provided. Option A) neuroblastoma is a common extracranial solid tumor in children, typically occurring in the adrenal glands. Option B) nephroblastoma, also known as Wilms tumor, is a kidney cancer that primarily affects young children. Option C) retinoblastoma is a malignant tumor of the retina that often presents in early childhood. Understanding the likelihood of different malignancies in pediatric patients is crucial for healthcare providers when assessing and managing young patients. By recognizing the age prevalence and typical presentations of various pediatric cancers, healthcare professionals can appropriately evaluate and treat these conditions in a timely manner. This knowledge is essential for pediatricians, oncologists, and other healthcare providers caring for infants and children.

Correct Answer: B

Rationale: In discussing the risk of radiotherapy in children with medulloblastoma, it is crucial to address the concerns of parents regarding late neurological complications. Option B, "children with an age of less than 3 years," is the correct answer for the statement about late neurological sequelae post radiotherapy being more severe. This is because younger children have developing brains that are more sensitive to the effects of radiation, leading to increased risk and severity of neurological complications. Option A, "focal radiotherapy rather than craniospinal irradiation," is incorrect because craniospinal irradiation often involves a larger area but does not necessarily correlate with increased severity of late neurological sequelae. Option C, "concomitant chemo-radiotherapy," is incorrect as the addition of chemotherapy does not specifically worsen late neurological complications compared to radiation alone. Option D, "low-grade tumors rather than high-grade tumors," is incorrect since tumor grade does not directly impact the severity of late neurological sequelae post radiotherapy. Educationally, this question highlights the importance of considering age as a significant factor in treatment decisions for pediatric patients with medulloblastoma undergoing radiotherapy. Understanding the impact of age on treatment outcomes and potential complications is essential for healthcare providers when discussing treatment options with parents and making informed decisions for the well-being of the child.