A 5 months child is brought for routine care. During auscultation of heart you find a short systolic murmur at left upper sternal border with soft 2nd heart sound. The most likely diagnosis is?

Correct Answer: B

Rationale: The most likely diagnosis for a 5-month-old child presenting with a short systolic murmur at the left upper sternal border with a soft 2nd heart sound is B) Atrial septal defect (ASD). Atrial septal defect is a congenital heart defect characterized by an abnormal opening between the atria, leading to a left-to-right shunt. This results in a murmur heard at the upper left sternal border due to increased blood flow across the tricuspid valve during systole. The soft 2nd heart sound is due to reduced blood flow velocity through the pulmonic valve. Option A) Ventricular septal defect typically presents with a harsh holosystolic murmur at the lower left sternal border. Option C) Patent ductus arteriosus presents with a continuous machinery murmur. Option D) Pulmonary stenosis presents with a systolic ejection murmur at the left upper sternal border with an ejection click. Understanding and recognizing these different heart murmurs are essential for pediatric nurses to accurately assess and diagnose congenital heart defects in children. Early identification leads to prompt intervention and improved outcomes for pediatric patients with cardiac conditions.

Correct Answer: C

Rationale: The correct answer is C) Diurnal enuresis. Diurnal enuresis refers to the involuntary loss of urine during the daytime in individuals who should have developed bladder control. In the case of an adolescent with new-onset diabetes experiencing 'daytime accidents,' this term accurately describes their condition. Option A) Primary enuresis typically refers to bedwetting in children who have never been consistently dry at night. This term does not apply to the scenario of daytime accidents in an adolescent. Option B) Secondary enuresis is the term used when a child or adolescent starts wetting the bed again after having been dry for a significant period. This does not align with the daytime accidents described in the question. Option D) Nocturnal enuresis refers to bedwetting that occurs during the night. While related to bladder control, it does not address the specific issue of daytime accidents in the context of new-onset diabetes in an adolescent. Educationally, understanding the terminology related to enuresis is crucial for pediatric nurses caring for children and adolescents with bladder control issues. Recognizing the differences between primary, secondary, diurnal, and nocturnal enuresis aids in accurate assessment, diagnosis, and management of these conditions, leading to improved patient outcomes.

Correct Answer: C

Rationale: In the context of hemolytic uremic syndrome (HUS), the correct answer is C) Mild proteinuria, increased BUN and creatinine. This is because HUS is characterized by the triad of hemolytic anemia, thrombocytopenia, and acute kidney injury. The presence of mild proteinuria along with increased blood urea nitrogen (BUN) and creatinine levels indicates renal involvement, which is a key feature of HUS. Option A) Massive proteinuria, elevated BUN and creatinine is incorrect because massive proteinuria is not typically seen in HUS. Option B) Mild proteinuria, decreased BUN and creatinine is also incorrect as HUS is associated with increased, not decreased, BUN and creatinine levels. Option D) Massive proteinuria, decreased BUN and creatinine is incorrect due to the same reasons as options A and B. Educationally, understanding the laboratory findings associated with HUS is crucial for nurses caring for pediatric patients. Recognizing the specific pattern of mild proteinuria, along with increased BUN and creatinine, can aid in early identification and prompt management of HUS to prevent complications such as renal failure. This knowledge is vital in providing safe and effective care for children with HUS.

Correct Answer: B

Rationale: In discussing failure to thrive (FTT) with medical students, it is crucial to provide accurate and detailed information to enhance their understanding of this condition. The correct statement, option B, should be included in the discussion because it highlights the importance of evaluating a child's growth pattern over time rather than focusing on a single point in time. Monitoring a child's growth curve and noting significant deviations, such as crossing major percentile lines, is essential in identifying FTT early and initiating appropriate interventions. Option A is incorrect because using a single point, such as falling below the 25th percentile for weight, may not capture the dynamic nature of growth in children. FTT is a condition that requires longitudinal assessment rather than a one-time measurement. Option C is incorrect as it provides a specific threshold (less than 60% of the median weight) that may not be universally applicable across different populations and age groups. FTT diagnosis requires a comprehensive evaluation based on growth patterns rather than a fixed percentage. Option D is incorrect because while it acknowledges that some children naturally fall below the 3rd percentile, it overlooks the importance of assessing weight in conjunction with growth trends over time to differentiate between normal variation and pathological FTT. In an educational context, emphasizing the significance of growth monitoring and the interpretation of growth charts can help medical students develop the necessary skills to identify and manage FTT in pediatric patients effectively. Understanding the nuances of growth assessment and recognizing patterns indicative of FTT are essential skills for healthcare providers working with children and families.

Correct Answer: C

Rationale: In this question from the Essentials of Pediatric Nursing Test Bank, the correct answer is C) functional constipation. Functional constipation is the most likely cause of constipation in children. This is because functional constipation is a common issue in pediatric patients and is usually due to factors such as dietary habits, dehydration, lack of physical activity, or psychological issues. It is important to address these underlying causes to manage and prevent constipation in children effectively. Option A) hypothyroidism is less likely to be the cause of constipation in children unless there are specific signs and symptoms pointing towards thyroid dysfunction. Hirschsprung disease (Option B) is a congenital condition characterized by missing nerve cells in the colon, leading to severe constipation, but it is less common than functional constipation. Celiac disease (Option D) may cause digestive issues, but constipation is not a common symptom in children with celiac disease. In an educational context, understanding the common causes of constipation in pediatric patients is crucial for nurses and healthcare providers working with children. By recognizing the most likely causes of constipation, healthcare professionals can implement appropriate interventions and provide holistic care to improve the health and well-being of pediatric patients. This knowledge is essential for promoting optimal pediatric health outcomes.