A 5-year-old boy is brought by her mother complaining of frequent attacks of anger, sadness, and exaggerated startle response over the past weeks; the mother states he has prolonged periods of sitting alone as he doesn`t like to be with the others; he has been developed those symptoms immediately after experiencing a bad car accident with his father before weeks. Of the following, the MOST likely diagnosis is

Correct Answer: A

Rationale: In this scenario, the most likely diagnosis for the 5-year-old boy is acute posttraumatic stress disorder (PTSD) (Option A). Acute PTSD occurs when symptoms develop within the first month after exposure to a traumatic event, which in this case is the car accident. The child is displaying classic signs of PTSD, such as anger, sadness, exaggerated startle response, and social withdrawal. Option B, chronic PTSD, is incorrect because the symptoms have been present for only a few weeks, which is not enough time to diagnose chronic PTSD. Option C, delayed onset PTSD, is also incorrect because symptoms of delayed onset PTSD typically appear six months or more after the traumatic event, whereas in this case, symptoms developed immediately after the car accident. Option D, acute stress disorder, is incorrect because the timeframe for this diagnosis is shorter, usually lasting between 3 days to 1 month after the traumatic event. The key to choosing the correct answer lies in understanding the timeline of symptom onset in relation to the traumatic event. Educationally, this case highlights the importance of recognizing and understanding the different types of trauma-related disorders in pediatric patients. It emphasizes the need for early identification and intervention to support children who have experienced traumatic events and are exhibiting symptoms of PTSD. Recognizing these signs early on can lead to appropriate treatment and support for the child's mental health and well-being.

Correct Answer: D

Rationale: The correct answer is D) autism. Autism spectrum disorder (ASD) is characterized by stereotypic body movements, impaired communication skills, including verbal and nonverbal, and deficits in social interaction, such as absent empathy and difficulty forming friendships. Children with autism often struggle in social settings like daycare due to challenges in understanding social cues and forming relationships. Option A) Attention deficit hyperactivity disorder (ADHD) is primarily characterized by symptoms of inattention, hyperactivity, and impulsivity. While there may be some overlap in behaviors with autism, the absence of social communication deficits and stereotypic movements differentiate ADHD from autism. Option B) Dysthymic syndrome refers to a chronic type of depression characterized by a persistently low mood. This condition is not associated with the specific behavioral and social communication deficits seen in autism. Option C) Deaf-mutism is an outdated term and is not a recognized diagnosis. It refers to a combination of deafness and an inability to speak, which does not encompass the range of symptoms seen in autism. Educationally, understanding the key characteristics of autism is crucial for healthcare providers, especially those working in pediatric nursing. Recognizing the signs and symptoms early can lead to timely interventions and support for children with autism to improve their quality of life and developmental outcomes. Identifying the differences between autism and other conditions helps in making accurate diagnoses and providing appropriate care and resources for children and their families.

Correct Answer: C

Rationale: In pediatric nursing, understanding child behavior is crucial for providing effective care. When a 7-year-old child fails to cooperate with care in the hospital, one should suspect negativism. Negativism is a common behavior in young children where they resist or refuse to do what is asked of them. This can manifest as noncompliance with medical procedures or staff directives. Choosing option C as the correct answer is supported by the developmental stage of a 7-year-old child. At this age, children may exhibit negativism as they assert their independence and test boundaries. By recognizing this behavior as negativism, healthcare providers can approach the child with empathy and understanding, adapting strategies to encourage cooperation. Option A, immaturity, is not the best choice because failure to cooperate is more likely related to behavioral aspects rather than solely immaturity. Embarrassment (option B) is less likely in this context as it doesn't explain the consistent noncooperation. Fearfulness (option D) might be a factor, but negativism is a more common behavior in this age group. Educationally, understanding the psychological aspects of pediatric patients is essential for nurses to provide holistic care. By being aware of developmental behaviors like negativism, nurses can tailor their approach to build trust and rapport with pediatric patients, leading to better cooperation and positive health outcomes.

Correct Answer: C

Rationale: In this case, the correct diagnosis for the patient in Question 5 is C) obstructive sleep apnea syndrome. Obstructive sleep apnea syndrome is the likely diagnosis because the patient's symptoms, which may include snoring, gasping during sleep, daytime sleepiness, and pauses in breathing, are consistent with this condition. Option A, tonsillitis, is less likely as the symptoms described do not align with the typical presentation of tonsillitis, which includes sore throat, fever, and difficulty swallowing. Option B, peritonsillar abscess, is also less likely as this condition is characterized by severe throat pain, difficulty opening the mouth, and a muffled voice, which are not mentioned in the scenario. Option D, Tangier disease, is an extremely rare genetic disorder characterized by the absence of high-density lipoprotein (HDL) in the blood, leading to a range of health issues, but it is not related to the symptoms described in the question. Educationally, understanding the differences in presentation, symptoms, and diagnostic criteria for various pediatric conditions is crucial for nurses caring for pediatric patients. Recognizing the signs of obstructive sleep apnea syndrome in children is important as it can have significant impacts on their health and well-being if left untreated. By discussing and differentiating between these conditions, nurses can enhance their clinical reasoning skills and provide effective care for pediatric patients.

Correct Answer: B

Rationale: In pediatric nursing, it is crucial to understand the impact of radiation sensitivity in certain diseases. The correct answer is B) Gardner syndrome because it is not associated with sensitivity to radiation. A) Ataxia-telangiectasia is a genetic disorder characterized by sensitivity to radiation due to defects in repairing DNA damage caused by radiation exposure. Individuals with this syndrome are at higher risk for developing cancer. C) Down syndrome is associated with an increased risk of leukemia, and individuals with Down syndrome may have heightened sensitivity to radiation, making them more susceptible to radiation-induced complications. D) Fanconi anemia is a rare genetic disorder that results in bone marrow failure and increased sensitivity to DNA-damaging agents like radiation. Patients with Fanconi anemia are at risk of developing leukemia and other cancers due to their sensitivity to radiation. Educationally, understanding which diseases are associated with sensitivity to radiation is vital for pediatric nurses when caring for children with these conditions. It helps in implementing appropriate precautions to minimize radiation exposure and in providing specialized care to manage the potential risks associated with radiation sensitivity.