A 4-year-old hospitalized with failure to thrive (FTT) has orders for daily weights, strict I&O, and calorie counts. Which action by the nurse is a concern?

Correct Answer: A

Rationale: In this scenario, the correct action is option A - weighing the child every morning after breakfast is a concern. Weighing the child after eating can lead to inaccurate weight measurements due to the added weight of the food consumed. In a clinical setting where accurate monitoring of weight is crucial for assessing FTT, weighing the child before any food or drink intake would provide the most accurate baseline weight measurement. Option B - weighing the child with only undergarments on is important for achieving accurate weight measurements as clothing can add unnecessary weight. This practice ensures consistency in weight monitoring. Option C - sitting with the child while she eats her meals is a supportive measure to encourage adequate intake, which is beneficial for addressing failure to thrive in pediatric patients. Option D - weighing the child after she has been fed is incorrect as mentioned earlier, as it can lead to inaccurate weight measurements. It is essential to weigh the child before any food or drink intake to obtain the most accurate weight data. Educationally, this question highlights the importance of accurate weight monitoring in pediatric patients with failure to thrive. It emphasizes the significance of proper assessment techniques in clinical practice to ensure optimal patient care and treatment outcomes. This rationale underscores the critical role of nursing interventions in promoting the health and well-being of pediatric patients with FTT.

Correct Answer: D

Rationale: In this question from the ATI Pediatric Practice Questions exam, the correct answer is D) seizure. Abrupt withdrawal of baclofen, a muscle relaxant commonly used to treat spasticity, can lead to a withdrawal syndrome characterized by an increased risk of seizures. This occurs because baclofen acts on the central nervous system, and sudden discontinuation can disrupt the balance of neurotransmitters, leading to hyperexcitability and potential seizure activity. Option A) depression is incorrect because abrupt baclofen withdrawal is not typically associated with depressive symptoms. Option B) drowsiness is also incorrect as withdrawal is more likely to cause an increase in arousal state rather than drowsiness. Option C) headache is an unlikely symptom of baclofen withdrawal compared to the more serious risk of seizures. Educationally, this question highlights the importance of gradual tapering when discontinuing medications that act on the central nervous system to prevent withdrawal symptoms. It also emphasizes the need for healthcare providers to be aware of potential adverse effects of medication withdrawal to ensure patient safety and well-being.

Correct Answer: B

Rationale: In the context of pediatric care, swaddling plays a crucial role in soothing infants and promoting better sleep patterns. Option B, "swaddling is effective if practiced before a crying episode," is the correct answer in this scenario. Swaddling a baby before they start crying helps in preventing overstimulation and promotes a sense of security and comfort for the infant, leading to a calmer state. This practice can also help in establishing a bedtime routine and aiding in the self-soothing process for the baby. Option A, stating that swaddling is effective during a crying episode, is incorrect because by the time a baby is already crying, it may be challenging to calm them down solely through swaddling. Option C, claiming that there is no place for swaddling to calm a crying infant, is incorrect as swaddling has been shown to be an effective technique in calming fussy or colicky infants. Option D, suggesting that swaddling may interfere with vascular supply, is also incorrect as long as swaddling is done correctly, ensuring that the baby's circulation is not compromised. Educationally, understanding the correct timing and technique of swaddling is essential for healthcare providers, caregivers, and parents to promote the well-being of infants. By knowing when and how to swaddle effectively, they can enhance the comfort and sleep quality of the baby, leading to better overall care and development.

Correct Answer: C

Rationale: In pediatric oncology, Acute Lymphoblastic Leukemia (ALL) is the most common type of childhood cancer. Children with ALL who carry a poor outcome often present with specific risk factors. The correct answer, option C, hyperdiploidy chromosomal abnormality, is not associated with a poor outcome in ALL. Hyperdiploidy is actually a favorable prognostic factor as it is linked to a better response to treatment and improved outcomes. Option A, age younger than 1 year and older than 10 years, is associated with a poor outcome in ALL because younger children often have more aggressive forms of the disease, while older children may have treatment-related complications or higher relapse rates. Option B, T-cell immunophenotype, is also linked to a poor outcome due to its association with higher resistance to treatment and increased risk of relapse. Option D, initial leukocyte count of > 50,000, is a poor prognostic factor as it indicates a higher tumor burden and is associated with a more aggressive disease course. In an educational context, understanding the prognostic factors in pediatric ALL is crucial for healthcare providers involved in the care of children with cancer. This knowledge can guide treatment decisions, help predict outcomes, and tailor therapies to improve patient outcomes. It is essential for nurses, physicians, and other healthcare professionals to be well-versed in these prognostic factors to provide optimal care and support to pediatric patients with ALL.

Correct Answer: A

Rationale: In this question, the correct answer is A) medulloblastoma. Extraneural metastasis from primary brain tumors is most commonly seen in medulloblastoma. Medulloblastoma is a highly malignant brain tumor that tends to spread through cerebrospinal fluid to other parts of the body, leading to extraneural metastasis. Primitive neuroectodermal tumor (PNET) and ependymoma are less likely to metastasize outside the central nervous system compared to medulloblastoma. Malignant gliomas are more likely to invade surrounding brain tissue rather than metastasize outside the CNS. In an educational context, understanding the likelihood of extraneural metastasis from different types of brain tumors is crucial for healthcare providers caring for pediatric patients with brain tumors. This knowledge can guide treatment decisions, follow-up care, and discussions with patients and their families about prognosis and potential complications.