A 6-year-old boy with hereditary spherocytosis developed transient aplastic crisis following a recent viral infection. The most probable incriminated viral infection is:

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Parvovirus type B 19. Parvovirus B19 is known to cause transient aplastic crisis in patients with hereditary spherocytosis due to their increased susceptibility to parvovirus infections. Parvovirus B19 specifically targets red blood cell precursors, leading to a temporary halt in red blood cell production, exacerbating anemia in these patients. Option A) German measles virus (rubella) does not typically cause aplastic crisis in hereditary spherocytosis. Option B) Human herpes virus 6 and Option C) Adenovirus are not commonly associated with aplastic crisis in these patients either. Educationally, understanding the relationship between specific viral infections and their effects on patients with underlying conditions like hereditary spherocytosis is crucial for pediatric nurses. This knowledge aids in early recognition of potential complications, appropriate management, and patient education. It also highlights the importance of tailored care for pediatric patients with underlying hematologic disorders during viral infections.

Correct Answer: A

Rationale: The correct answer is A) is old enough to understand the word no. At 10 months old, infants like Megan are beginning to develop object permanence and basic understanding of cause and effect. They can start to associate actions with consequences, such as being told "no" in a firm tone. This age is a critical period for setting boundaries and teaching safety measures. By using simple language and consistent reinforcement, Megan can learn that certain behaviors are off-limits, like touching electrical outlets. Option B) is too young to understand the word no is incorrect because infants at 10 months old are capable of grasping simple commands and starting to comprehend restrictions. Option C) should already know that electric outlets are dangerous is incorrect as infants lack the cognitive ability to understand danger without explicit teaching. Option D) will learn safety issues better if she is spanked is not appropriate as physical punishment is not effective in teaching safety or promoting positive behavior in children. In an educational context, it is vital for nurses to provide parents with age-appropriate guidance on child development and safety practices. By explaining the cognitive abilities of infants and effective disciplinary strategies, nurses can empower parents to create a safe environment and foster healthy development in their children.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Discuss with the parents the importance of appropriate clothing for infants. This option is the most appropriate response because it focuses on the importance of appropriate clothing for infants rather than making assumptions about the family's financial situation or offering unsolicited advice. Option A) Question the parents about their financial situation is invasive and could lead to unnecessary embarrassment or discomfort for the parents. It is not the nurse's role to pry into personal financial matters unless related to the child's health and safety. Option B) Ask the parents if they receive assistance for clothing also assumes financial need without any evidence. It may come across as judgmental and could strain the nurse-parent relationship. Option C) Advise the parents on budget-friendly clothing options could be perceived as condescending or presumptuous. It is essential to approach discussions about clothing with sensitivity and respect for the parents' choices and circumstances. In an educational context, it is crucial for nursing students to understand the importance of cultural sensitivity, professionalism, and non-judgmental communication when interacting with families. Discussing the significance of appropriate clothing for infants can be a way to educate parents on factors like safety, comfort, and developmental needs without making assumptions or passing judgment. It promotes a collaborative and respectful approach to addressing parenting concerns.

Correct Answer: D

Rationale: The correct answer is D) 8-12 years for the mean age range of breast bud appearance (thelarche) in females. This age range aligns with the typical onset of breast development in girls during puberty. It is important to understand the normal variations in the timing of pubertal milestones to monitor for any deviations that may indicate underlying health concerns. Option A) 5-9 years is too early for the average age of thelarche in females. Girls typically experience breast development closer to the onset of puberty around ages 8-12 years. Option B) 6-10 years is also too early for the mean age range of thelarche. While some girls may start developing breasts around age 6, it is not the average age for this pubertal milestone. Option C) 7-11 years is closer to the correct range, but it still underestimates the typical age range for breast bud appearance in females. Puberty usually begins around 8-12 years of age, which is when breast development commonly starts. Understanding the normal progression of puberty milestones in pediatric nursing is crucial for assessing growth and development, identifying potential health issues, and providing appropriate support and education to patients and their families. By knowing the average age range for thelarche, nurses can offer anticipatory guidance and address any concerns related to puberty in young girls effectively.

Correct Answer: B

Rationale: The correct answer is B) amphetamine. The presentation described aligns with amphetamine toxicity symptoms, including delusions, paranoia, tachycardia, hypertension, hyperpyrexia, diaphoresis, piloerection, mydriasis, hyperreflexia, seizures, hypotension, and dysrhythmia. Understanding the effects of amphetamines is crucial in pediatric nursing as they are increasingly misused by adolescents for various reasons, leading to potentially life-threatening situations. Option A) antidepressant agents typically do not cause the array of symptoms described. Barbiturates (C) usually present with respiratory depression, hypotension, and CNS depression, not the hyperstimulation seen in the case. Benzodiazepines (D) would manifest with CNS depression, sedation, and respiratory depression, contrasting the symptoms presented. Educationally, this question reinforces the importance of recognizing drug toxicity in adolescents, highlighting the need for vigilance in assessment and the critical role of pediatric nurses in identifying and managing such cases promptly to prevent adverse outcomes. Understanding these distinctions is vital for providing safe and effective care to pediatric patients.