A 5 -g infant underwent extensive intestinal resection for severe necrotizing enterocolitis on the th day of life In the second month of life, the child gradually manifested edema; an erythematous rash on the distal extremities, mouth, and perineal region; and alopecia The most appropriate therapy for this patient is to

Correct Answer: D

Rationale: The correct answer is D) Administer zinc. In this scenario, the infant is presenting with symptoms suggestive of zinc deficiency, such as edema, rash, and alopecia. Zinc plays a crucial role in growth, immune function, and wound healing, making it essential for infants recovering from surgery and with compromised intestinal function like in necrotizing enterocolitis. Administering zinc supplementation is necessary to address the deficiency and support the infant's overall health and recovery. Option A) Administer salt-poor albumin is incorrect because the infant's symptoms are not indicative of hypoalbuminemia but rather point towards a specific mineral deficiency. Option B) Increasing the protein content in the hyperalimentation solution is not the appropriate intervention in this case because the symptoms are more likely related to a specific micronutrient deficiency rather than a general macronutrient deficiency. Option C) Administering recombinant alkaline phosphatase is unnecessary as the symptoms are not indicative of alkaline phosphatase deficiency. This intervention would not address the specific issues presented in the case. In an educational context, understanding the signs and symptoms of common nutrient deficiencies in pediatric patients is crucial for nurses caring for infants with complex medical histories like extensive intestinal resection. Recognizing and appropriately addressing these deficiencies through targeted interventions, such as zinc supplementation in this case, are vital for optimizing patient outcomes and promoting recovery.

Correct Answer: B

Rationale: In pediatric nursing, understanding child development and behavior is crucial for providing effective care. The correct answer, option B, "It indicates a potential for future lying behavior," is not true because frequent lying behavior in a 3-year-old is developmentally appropriate and does not necessarily predict future lying tendencies. Young children engage in fantasy play and storytelling as part of their cognitive and social development, rather than with the intent to deceive. Option A, "It is a method of playing with language," is a common behavior in preschool-aged children as they explore language and communication skills through imaginative play. Option C, "It is a part of magical thinking," is also accurate as young children often have difficulty distinguishing between fantasy and reality at this age. Option D, "It is an approach to avoid unwanted confrontation with adults," may seem plausible, but at the age of 3, children are more likely to lie as a form of creative play or to test boundaries rather than to consciously avoid confrontation. Educationally, it is important for pediatric nurses to have a solid understanding of child development to differentiate between normal behaviors and potential concerns. By recognizing typical behaviors like frequent lying in young children as part of their development, healthcare providers can offer appropriate support and guidance to both the child and their caregivers.

Correct Answer: D

Rationale: In evaluating a symptomatic toddler for autistic spectrum disorders, the test that should NOT be included is a Woods lamp examination, making option D the correct answer. A Woods lamp is used to detect certain skin conditions like fungal infections or pigment changes, and it is not a standard diagnostic tool for evaluating autism spectrum disorders. Physical examination (option A) is essential to assess the overall health and developmental milestones of the child. Hearing tests (option B) are crucial to rule out any hearing impairments that might be affecting the child's communication skills. A brain CT scan (option C) may be ordered to evaluate any structural abnormalities in the brain, which can sometimes be associated with certain developmental disorders but is not typically used as a primary tool for diagnosing autism spectrum disorders. In the context of pediatric nursing, it is important to prioritize evidence-based assessment tools and diagnostic tests that are relevant to the specific condition being evaluated. Understanding the rationale behind choosing or excluding certain tests is crucial for providing optimal care to pediatric patients.

Correct Answer: A

Rationale: In this case, the most appropriate diagnosis for the 7-year-old boy presenting with recurrent eye blinking behavior and recurrent extension of extremities is A) Tourette's disorder. Tourette's disorder is characterized by the presence of both multiple motor and one or more vocal tics, which are sudden, rapid, and repetitive movements or sounds. The symptoms described by the mother align with the diagnostic criteria for Tourette's disorder. Option B) persistent motor tic disorder refers to the presence of motor tics without vocal tics for at least 1 year, which does not fit the presentation described in the question. Option C) provisional tic disorder involves the presence of motor or vocal tics for less than 1 year, which is also inconsistent with the duration of symptoms in this case. Option D) post-viral encephalitis is unlikely given the chronic nature of the symptoms and the absence of other signs of encephalitis. Educationally, understanding the differences between these disorders is crucial for healthcare providers working with pediatric patients. Recognizing the specific criteria for Tourette's disorder, persistent motor tic disorder, and provisional tic disorder is essential for accurate diagnosis and appropriate management. This case highlights the importance of thorough assessment and knowledge of developmental disorders in pediatric nursing practice.

Correct Answer: B

Rationale: The correct answer is B) behavioral instruction to parents and follow-up. Breath-holding spells are typically benign in nature and self-limiting. They are usually triggered by emotional upset or frustration in young children. Therefore, reassurance is the most appropriate response as it helps alleviate parental anxiety and stress. Ordering an MRI brain (option C) is unnecessary for a child with classic breath-holding spells as they have a typical presentation and do not require neuroimaging. Similarly, ordering an ECG (option D) is not indicated in this case as breath-holding spells are not cardiac in nature. Educationally, it is important for healthcare providers to have a good understanding of common pediatric conditions such as breath-holding spells to provide appropriate care and guidance to parents. By recognizing the typical presentation and course of these spells, unnecessary investigations and interventions can be avoided, leading to better patient outcomes and cost-effective care.