A 6-year-old girl complains of recurrent attacks of headache over the past 6 months; she has a fear of having brain tumor in spite of normal clinical and radiological findings; she has an underlying depression disorder. Of the following, the MOST likely diagnosis is

Correct Answer: D

Rationale: The correct answer is D) hypochondriasis. In this case, the 6-year-old girl's fear of having a brain tumor despite normal clinical and radiological findings points towards hypochondriasis, a condition characterized by a preoccupation with having a serious illness. This disorder involves excessive worry about health and a persistent belief of having a serious medical condition despite evidence to the contrary. Option A) undifferentiated somatoform disorder refers to physical symptoms causing distress without a clear medical explanation, but in this case, the focus is specifically on the fear of having a brain tumor. Option B) conversion disorder involves neurological symptoms that cannot be explained by medical evaluation; however, the primary symptom in this case is not neurological. Option C) pain disorder is characterized by pain as the predominant focus of clinical presentation, which is not the case here. In an educational context, understanding pediatric psychiatric disorders is crucial for nursing practice. Recognizing the signs and symptoms of hypochondriasis in children is important for early intervention and appropriate management. By differentiating between various somatic symptom and related disorders, nurses can provide holistic care for children with mental health concerns.

Correct Answer: B

Rationale: In the context of pediatric nursing and the treatment of autism spectrum disorders (ASDs), it is important to understand the use of stimulant drugs. The correct answer, option B) Asperger syndrome, is the best response to these drugs for several reasons. Stimulant drugs, such as those used to treat attention-deficit/hyperactivity disorder (ADHD), are often prescribed to address symptoms of hyperactivity and inattention. Individuals with Asperger syndrome may exhibit these symptoms in addition to social difficulties and repetitive behaviors commonly seen in ASDs. Stimulant medications can help improve focus, reduce impulsivity, and enhance cognitive functioning in individuals with Asperger syndrome, leading to better overall functioning and quality of life. Regarding the other options: - Option A) autism: While individuals with autism may also experience symptoms of hyperactivity and inattention, stimulant drugs may not be as effective due to the complexity and variability of symptoms within the autism spectrum. - Option C) childhood disintegrative disorder: This is a rare condition characterized by a loss of previously acquired skills, and stimulant drugs are not typically indicated for its management. - Option D) Rett syndrome: This is a genetic disorder that primarily affects girls and is characterized by developmental regression, motor impairments, and repetitive hand movements. Stimulant drugs are not appropriate for the management of symptoms associated with Rett syndrome. In an educational context, understanding the nuances of pharmacological interventions for different conditions within the ASD spectrum is crucial for pediatric nurses. By grasping which medications are most effective for specific symptoms and disorders, nurses can play a vital role in advocating for the optimal care and treatment of children with ASDs. It is essential to consider individual differences, co-occurring conditions, and the potential benefits and risks of medication therapy when caring for pediatric patients with ASDs.

Correct Answer: D

Rationale: Night terrors are associated with the correct answer choice D, which states "inception in preschool years and sometimes somnambulism." Night terrors are a type of sleep disorder that typically occurs during non-REM sleep, particularly during the deep sleep stages. They are more common in children, especially in the preschool years when sleep patterns are still developing. Night terrors are different from nightmares and are characterized by sudden awakenings with intense fear and confusion. Option A, REM sleep, is incorrect because night terrors occur during non-REM sleep. Option B, overeating after 7:00 p.m., is unrelated to the cause of night terrors. Option C, the use of antipsychotic medication, is also incorrect as night terrors are not typically associated with this type of medication. In an educational context, understanding the association of night terrors with the preschool years and somnambulism is crucial for pediatric nurses. By recognizing the typical onset age of night terrors and their characteristics, nurses can provide appropriate education and support to parents and caregivers dealing with a child experiencing night terrors. Additionally, this knowledge helps nurses differentiate night terrors from other sleep disorders and provide effective interventions to manage them.

Correct Answer: D

Rationale: In pediatric nursing, understanding psychosocial problems and their manifestations is crucial for providing holistic care to children. The correct answer is D) performance. Psychosocial problems can indeed manifest as disturbances in a child's performance, such as in school, social interactions, or extracurricular activities. This can include a decline in academic performance, withdrawal from social situations, or changes in behavior. Option A) feelings is incorrect because while psychosocial problems can impact a child's emotions, the primary manifestation is often seen in their performance and functioning. Option B) body function is also incorrect as psychosocial issues primarily affect the mental and emotional aspects rather than physical functions. Option C) behavior is a close distractor, but it is not as comprehensive as performance, which encompasses a wider range of areas where psychosocial problems can manifest. Educationally, understanding how psychosocial problems present themselves in children is essential for pediatric nurses to assess, intervene, and support these young patients effectively. By recognizing disturbances in performance, nurses can collaborate with other healthcare professionals and caregivers to develop a comprehensive care plan that addresses the child's psychosocial needs alongside their physical health.

Correct Answer: B

Rationale: In pediatric nursing, understanding risk factors for obstructive sleep apnea syndrome is crucial for early identification and intervention. The correct answer, B) small triangular chin, is not a recognized risk factor for obstructive sleep apnea syndrome in children. A) Retroposition of the mandible can contribute to airway obstruction, leading to sleep apnea. C) Long oval face is associated with craniofacial anomalies that can increase the risk of airway blockage during sleep. D) A long or soft palate can also obstruct the airway, leading to breathing difficulties during sleep. Educationally, knowing these risk factors helps nurses in pediatric care to assess children for potential sleep disorders. By differentiating between valid and invalid risk factors, nurses can provide targeted care and interventions, such as referrals to specialists for further evaluation and management. This knowledge enhances the quality of care provided to pediatric patients, promoting better health outcomes.