A 5-year-old is noted by the parents to snore at night. The child has also had problems staying awake in preschool and has had behavioral problems. The father also snores. Physical examination of the child reveals large, pink, nonexudative tonsils. The most appropriate next step is

Correct Answer: B

Rationale: In this scenario, the most appropriate next step is option B) polysomnography. Polysomnography is the gold standard diagnostic test for assessing sleep disorders, including obstructive sleep apnea (OSA) in children. OSA is a common condition in pediatric patients with symptoms like snoring, excessive daytime sleepiness, and behavioral issues. Laryngoscopy (option A) is not the initial step in diagnosing OSA in children. It is more invasive and less commonly used compared to polysomnography. Ambulatory apnea monitor (option C) is typically used for home monitoring but may not provide as comprehensive data as polysomnography. Telemetry (option D) is not a relevant option in this context. Educationally, understanding the appropriate diagnostic tests for common pediatric conditions like OSA is crucial for nurses working with children. By choosing polysomnography in this case, healthcare providers can accurately diagnose and manage the child's sleep disorder, leading to improved overall health and quality of life.

Correct Answer: A

Rationale: Rationale: The correct answer is A) low in calories. Mushrooms are considered an ideal food choice for various reasons. Firstly, they are low in calories, making them a great option for individuals looking to manage their weight or maintain a healthy diet. Mushrooms are also high in essential nutrients like vitamins, minerals, and antioxidants, making them a nutritious choice for overall health. Option B) high in calories is incorrect because mushrooms are actually one of the lowest-calorie foods available. They are mostly water and contain very few calories per serving, making them a great choice for those monitoring their calorie intake. Option C) high in fat is incorrect as well. Mushrooms are naturally low in fat, particularly saturated fat, which is beneficial for heart health and overall well-being. They are a good source of essential nutrients without adding unnecessary fats to the diet. Option D) low in fat is incorrect because mushrooms are indeed low in fat, not high. Their low-fat content, combined with being low in calories, makes them a healthy option for a balanced diet. From an educational standpoint, understanding the nutritional content of various foods is crucial for healthcare professionals, especially in pediatric nursing. Teaching families about healthy eating habits and food choices for children is a key aspect of promoting optimal growth and development. By knowing that mushrooms are low in calories and fat, nurses can educate parents on incorporating nutrient-rich foods like mushrooms into their child's diet to support their overall health and well-being.

Correct Answer: B

Rationale: In differentiating between organophosphate poisoning, methamphetamine intoxication, and bark scorpion envenomation, the presence of roving eye movements is a key feature specific to methamphetamine intoxication. Roving eye movements, also known as nystagmus, are a characteristic sign of CNS stimulation seen in methamphetamine toxicity. Choosing paresthesias (A) is incorrect as it is a common feature of organophosphate poisoning and scorpion envenomation, not methamphetamine intoxication. Cranial nerve dysfunction (C) is more likely to be associated with organophosphate poisoning due to its neurotoxic effects on the nervous system. Seizures (D) can occur in both organophosphate poisoning and scorpion envenomation but are not specific to methamphetamine intoxication. In an educational context, understanding the distinct clinical manifestations of various toxicological emergencies is crucial for pediatric nurses. Recognizing these differences enables prompt and accurate assessment, intervention, and management, which are essential in providing safe and effective care to pediatric patients presenting with poisoning or envenomation.

Correct Answer: C

Rationale: In pediatric nursing, understanding the complications of allergic rhinitis is crucial for providing optimal care to children. The correct answer, option C - thick nasal secretions, is the most likely clue to secondary bacterial infection like sinusitis. Thick nasal secretions are often a sign of infection as the body produces more mucus to combat the invading bacteria. This change in consistency is a key indicator for healthcare providers to suspect a bacterial component in the presentation. Option A - hyperemia, refers to redness of the nasal mucosa, which can be seen in both allergic rhinitis and bacterial infections, making it a less specific clue for infection. Option B - swollen turbinates, is a common finding in allergic rhinitis due to inflammation and may not necessarily point towards a bacterial superinfection. Option D - bluish mucous membranes, is not a typical sign of bacterial infection and would be more concerning for a lack of oxygenation. Educationally, this question highlights the importance of recognizing subtle changes in clinical presentation to differentiate between allergic reactions and potential bacterial complications. Nurses need to be vigilant in assessing the quality of nasal secretions in children with allergic rhinitis to promptly identify and address any secondary infections to prevent further complications.

Correct Answer: C

Rationale: In pediatric nursing, understanding the risk factors for persistent asthma is crucial for providing effective care to children. The major risk factor for persistent asthma among the options provided is wheezing apart from colds (Option C). Wheezing apart from colds indicates ongoing airway inflammation and hyperresponsiveness, which are key features of persistent asthma. This symptom suggests a chronic underlying respiratory condition that requires ongoing management and monitoring. Eczema (Option A) and allergic rhinitis (Option B) are common comorbidities seen in children with asthma, but they are not considered major risk factors for persistent asthma. While they may exacerbate asthma symptoms, they do not necessarily predict the chronicity or severity of the condition. Food allergen sensitization (Option D) is more relevant to acute allergic reactions rather than the persistence of asthma symptoms. While food allergies can trigger asthma exacerbations in some individuals, they are not the primary risk factor for persistent asthma. Educationally, this question highlights the importance of recognizing the key indicators of persistent asthma in children. By understanding the significance of wheezing apart from colds as a major risk factor, nurses can intervene early, initiate appropriate treatment, and collaborate with healthcare providers to manage asthma effectively in pediatric patients.