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: In this scenario, the most appropriate therapy for the infant presenting with edema, rash, and alopecia post-extensive intestinal resection for necrotizing enterocolitis is option D: Administer zinc. Zinc deficiency is common in pediatric patients with malabsorption issues like short bowel syndrome post-intestinal resection. Zinc plays a crucial role in immune function, wound healing, and skin integrity. The symptoms described (edema, rash, alopecia) are consistent with zinc deficiency. Administering zinc supplementation can help alleviate these symptoms and support the infant's overall health and development. Option A (Administer salt-poor albumin) is incorrect because the symptoms presented are not indicative of a need for albumin administration. Option B (Increase the protein content in the hyperalimentation solution) is incorrect because the symptoms are not due to protein deficiency but rather a specific micronutrient deficiency. Option C (Administer recombinant alkaline phosphatase) is incorrect as it does not address the symptoms associated with zinc deficiency in this case. In an educational context, understanding the specific nutritional requirements of pediatric patients post-intestinal resection is crucial for providing optimal care. This case highlights the importance of recognizing the clinical manifestations of nutrient deficiencies and tailoring treatment strategies accordingly to promote the best outcomes for pediatric patients.

Correct Answer: B

Rationale: In pediatric nursing, understanding the behavior of children, including lying, is crucial for providing appropriate care. The correct answer, B) It indicates a potential for future lying behavior, is true because frequent lying in a 3-year-old may not necessarily predict future lying tendencies. At this age, children are still developing a sense of reality and fantasy, and their imaginative play may involve storytelling that is not intended to deceive. Option A) It is a method of playing with language, is incorrect because while children may use language creatively in play, lying typically involves intentionally deceiving others, which is not the primary goal of a 3-year-old's behavior. Option C) It is a part of magical thinking, is incorrect as well. Magical thinking in children involves believing in fantasy or supernatural events, not necessarily intentional deception through lying. Option D) It is an approach to avoid unwanted confrontation with adults, is also incorrect because at age 3, children may not have developed the cognitive skills to strategize lying as a means to avoid confrontation. In an educational context, it is important for healthcare providers to understand the developmental stages of children to interpret their behaviors accurately. By recognizing that frequent lying in a young child is often linked to their cognitive and imaginative development rather than a precursor to future dishonesty, healthcare professionals can provide appropriate guidance and support to both the child and their caregivers.

Correct Answer: D

Rationale: In pediatric nursing, evaluating a symptomatic toddler for autistic spectrum disorders requires a comprehensive assessment. The correct answer, option D) Woods lamp, should not be included in this evaluation. A Woods lamp is used to assess skin conditions like fungal infections or pigment changes, which are not directly related to the core symptoms of autism spectrum disorders. Option A) Physical examination is crucial to assess the overall health of the child and rule out any physical abnormalities that could be causing symptoms resembling autism. Option B) Hearing tests are important to evaluate the child's auditory processing, as hearing difficulties can sometimes present similarly to autism symptoms. Option C) Brain CT is not typically used as a routine diagnostic tool for autism spectrum disorders. Diagnosing autism involves behavioral observations, developmental history, and standardized assessments rather than neuroimaging studies like CT scans. In an educational context, understanding the rationale behind selecting appropriate diagnostic tests is essential for providing quality care to pediatric patients. By knowing which tests are relevant and which are not, nurses can ensure accurate assessments and timely interventions for children with developmental concerns.

Correct Answer: A

Rationale: In this case, the most appropriate diagnosis is Tourette's disorder (Option A). Tourette's disorder is characterized by the presence of both motor and vocal tics lasting for more than a year. The scenario describes the presence of recurrent eye blinking behavior and recurrent extension of extremities, which are classic motor tics seen in Tourette's disorder. Option B, persistent motor tic disorder, is incorrect because this diagnosis requires the presence of motor tics only, without any vocal tics, which is not the case in this scenario. Option C, provisional tic disorder, is not the best choice as this diagnosis is used when the tics have been present for less than a year, and this patient has been experiencing symptoms for the last 9 months, exceeding the time frame for provisional tic disorder. Option D, post-viral encephalitis, is not the correct diagnosis as the symptoms described are more characteristic of a tic disorder rather than an encephalitis-related condition. Educationally, understanding the differentiation between various tic disorders is crucial for pediatric nurses to accurately assess and diagnose children presenting with these symptoms. Recognizing the specific criteria for each disorder helps in providing appropriate interventions and support for the child and their family.

Correct Answer: B

Rationale: The correct answer is B) behavioral instruction to parents and follow-up. Breath-holding spells are common in young children and are usually benign. Reassurance to the parents is important because these spells can be distressing to witness but typically do not cause harm to the child. Ordering an MRI of the brain or an ECG is not indicated in the evaluation of breath-holding spells unless there are atypical features or concerning symptoms present, which are not described in this case. Educationally, it is crucial to understand the common presentations and management of pediatric conditions like breath-holding spells. By recognizing the typical characteristics of these spells and knowing when further investigations are warranted, healthcare providers can provide appropriate care and guidance to parents. This case highlights the importance of clinical judgment and evidence-based practice in pediatric nursing.