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: In this scenario, the MOST likely diagnosis for the 6-year-old girl with recurrent headaches, fear of a brain tumor, normal clinical and radiological findings, and underlying depression disorder is hypochondriasis (Option D). Hypochondriasis, also known as illness anxiety disorder, is characterized by excessive worry about having a serious illness despite medical reassurance and lack of supporting medical evidence. In this case, the child's persistent fear of having a brain tumor despite normal test results aligns with this diagnosis. The presence of an underlying depression disorder further supports this diagnosis, as anxiety and depressive disorders are commonly comorbid. Option A, undifferentiated somatoform disorder, involves physical symptoms without a clear medical explanation, but it does not specifically encompass the intense fear of having a serious illness seen in hypochondriasis. Conversion disorder (Option B) usually presents with neurological symptoms that are not intentionally produced, making it less likely in this case. Pain disorder (Option C) focuses on pain as a predominant factor, which does not fully capture the complexity of the child's presentation. Educationally, understanding the nuances of different somatic symptom and related disorders is crucial in pediatric nursing practice. Recognizing the interplay between physical symptoms, emotional distress, and cognitive factors is essential for providing holistic care to pediatric patients with complex presentations like the one described. By differentiating between these disorders, nurses can better advocate for appropriate interventions and support for their young patients.

Correct Answer: B

Rationale: The correct answer is B) Asperger syndrome. Stimulant drugs, such as methylphenidate, are commonly used to treat symptoms of hyperactivity and inattention in individuals with ASDs. Asperger syndrome is a form of ASD where individuals often exhibit symptoms of inattention and hyperactivity similar to those seen in attention deficit hyperactivity disorder (ADHD). Therefore, stimulant drugs are more likely to be effective in managing these specific symptoms in individuals with Asperger syndrome. Option A) autism is not the best response because autism itself is a spectrum disorder with a wide range of symptoms and presentations, and stimulant drugs may not always be the most effective treatment for all individuals with autism. Option C) childhood disintegrative disorder is a rare condition characterized by a loss of previously acquired skills, including language and social abilities, and stimulant drugs are not typically indicated for the core symptoms of this disorder. Option D) Rett syndrome is a genetic disorder primarily affecting girls and is characterized by a regression of motor and communication skills, as well as the presence of repetitive hand movements. Stimulant drugs are not considered appropriate for managing the symptoms of Rett syndrome. In an educational context, understanding the specific characteristics of different ASDs and the appropriate pharmacological interventions is crucial for healthcare professionals working with pediatric patients. This knowledge helps in individualizing treatment plans to address the unique needs of each child with an ASD, ensuring optimal outcomes and quality of life.

Correct Answer: D

Rationale: The correct answer is D) inception in preschool years and sometimes somnambulism. Night terrors are a common parasomnia in childhood, typically starting in the preschool years when children experience partial arousal from deep sleep stages. This can lead to intense fear, screaming, and confusion, often accompanied by physical symptoms like increased heart rate and sweating. Sometimes, night terrors can progress to somnambulism, or sleepwalking, in which the child may walk around or engage in other activities while still asleep. Option A) REM sleep is incorrect because night terrors are not associated with REM sleep, but rather with disruptions in non-REM sleep stages. Option B) overeating after 7:00 p.m. is incorrect because while diet can impact sleep patterns, it is not a direct cause of night terrors. Option C) the use of antipsychotic medication is incorrect because night terrors are not typically caused by antipsychotic medication in children. In an educational context, understanding the causes and characteristics of night terrors is crucial for pediatric nurses to provide appropriate care and support to children and their families. By recognizing the onset in preschool years and potential progression to somnambulism, nurses can offer guidance on sleep hygiene, stress management, and other interventions to help manage and reduce the occurrence of night terrors in children.

Correct Answer: D

Rationale: In pediatric nursing practice, understanding how psychosocial problems manifest is crucial for providing holistic care to children. The correct answer is D) performance. Psychosocial problems can impact a child's overall performance in various areas of life, such as academic performance, social interactions, and activities of daily living. By addressing these performance-related issues, nurses can help children cope better and improve their overall well-being. Option A) feelings may seem like a plausible choice as psychosocial problems can indeed affect a child's emotions. However, the question specifically asks about manifestations, and feelings alone may not always be outwardly visible or measurable. Option B) body function is more related to physiological problems rather than psychosocial issues. While psychosocial factors can influence physical health, the direct impact on body functions is less common compared to effects on performance. Option C) behavior is closely linked to psychosocial problems, but focusing solely on behavior may overlook other important manifestations like cognitive difficulties or emotional disturbances that also impact a child's performance. Educationally, this question helps reinforce the importance of recognizing the diverse ways psychosocial problems can present in pediatric patients. By understanding these manifestations, nurses can intervene appropriately to support children's holistic well-being and development.

Correct Answer: B

Rationale: The correct answer is B) small triangular chin. In pediatric patients, risk factors for obstructive sleep apnea syndrome (OSAS) often involve anatomical features that can contribute to airway obstruction during sleep. A small triangular chin is not a typical risk factor for OSAS. Retroposition of the mandible (A) can lead to airway narrowing or collapse during sleep, contributing to OSAS. A long oval face (C) may be associated with craniofacial abnormalities that can predispose a child to OSAS. A long or soft palate (D) can also contribute to airway obstruction, as a large or floppy palate can block the airway during sleep. Educationally, understanding the risk factors for OSAS in pediatric patients is crucial for healthcare providers working in pediatric nursing. By recognizing these risk factors, nurses can screen and identify children who may be at risk for OSAS, allowing for early intervention and treatment to prevent complications associated with untreated sleep-disordered breathing in children.