A 6-year-old male patient presented with microcephaly, microphthalmia, absent thumb, ectopic kidney, and recurrent epistaxis. The most informative diagnostic test explaining the underlying etiology is:

Correct Answer: A

Rationale: The correct answer is option A) Chromosomal breakage test for this patient presenting with microcephaly, microphthalmia, absent thumb, ectopic kidney, and recurrent epistaxis. These clinical manifestations are indicative of a rare genetic disorder called Fanconi anemia, characterized by chromosomal instability leading to breakage and increased risk of malignancies. Option B) Hemoglobin electrophoresis is used to diagnose hemoglobinopathies like sickle cell disease, not relevant to this patient's presentation. Option C) Schilling test is used to assess vitamin B12 absorption, not related to the symptoms described. Option D) Osmotic fragility test is used to diagnose conditions like hereditary spherocytosis, which does not align with the patient's symptoms. In an educational context, understanding the rationale behind diagnostic testing based on presenting symptoms is crucial in pediatric nursing. Recognizing the pattern of anomalies and linking them to specific genetic disorders is essential for early diagnosis and appropriate management of pediatric patients with rare conditions like Fanconi anemia. This case highlights the importance of a comprehensive assessment and knowledge of diagnostic tests in pediatric nursing practice.

Correct Answer: A

Rationale: Normocytic normochromic anemia refers to a type of anemia where the red blood cells are normal in size and color. In this case, the correct answer is A) Aplastic anemia. Aplastic anemia is a disorder where the bone marrow fails to produce enough blood cells, leading to low levels of red blood cells, white blood cells, and platelets. This results in normocytic normochromic anemia due to the decreased production of red blood cells with normal size and hemoglobin content. Option B) a-Thalassemia is incorrect because it typically presents as microcytic hypochromic anemia, with small and pale red blood cells. Option C) Folic acid deficiency anemia is also incorrect as it results in macrocytic anemia, with large red blood cells. Option D) Iron deficiency anemia leads to microcytic hypochromic anemia, characterized by small and pale red blood cells. In an educational context, understanding the different types of anemia is crucial for nurses caring for pediatric patients. Recognizing the characteristics of normocytic normochromic anemia, such as in aplastic anemia, helps in providing appropriate care and interventions to manage the condition effectively. Nurses must be able to differentiate between the various types of anemia based on their etiology and characteristics to ensure accurate assessment and treatment for pediatric patients.

Correct Answer: A

Rationale: The correct answer is A) normal development. At 3 months of age, infants typically demonstrate a palmar grasp reflex, where they will grasp an object placed in their hand but may not voluntarily grasp objects. This behavior is considered within the normal developmental range for this age. It is important for nurses to understand typical developmental milestones to differentiate between normal variations and potential concerns. Option B) significant developmental lag is incorrect because the infant's behavior is not indicative of a significant delay given the age and expected developmental abilities at 3 months. Option C) slightly delayed development due to prematurity is incorrect because being born at 38 weeks of gestation is considered near-term and would not typically result in significant delays in motor development by 3 months of age. Option D) suggestive of a neurologic disorder such as cerebral palsy is incorrect as the behavior described is not specific to neurologic disorders at this age and stage of development. Educationally, understanding normal developmental milestones is crucial for healthcare providers working with pediatric populations. Recognizing typical behaviors helps identify deviations from the norm and allows for early intervention if necessary. This knowledge empowers nurses to provide appropriate support and guidance to families regarding their child's development.

Correct Answer: A

Rationale: In pediatric nursing, understanding the developmental needs of infants is crucial for providing effective care. In this scenario, the best play activity for a 6-month-old infant to provide tactile stimulation is allowing them to splash in a bath (Option A). The rationale behind this choice is that infants at this age are beginning to explore their environment through their senses, especially touch. Bath time not only provides a safe and supervised opportunity for tactile stimulation but also offers a multisensory experience through the sounds of water, warmth, and visual interest. Option B, giving various colored blocks, while beneficial for visual stimulation and hand-eye coordination, does not specifically target tactile stimulation, which is the primary focus here. Option C, playing music, is more auditory and not primarily focused on tactile input, which is essential for sensory development in infants. Option D, using an infant swing or stroller, provides movement and vestibular stimulation but lacks the direct tactile engagement that splashing in a bath offers. In an educational context, understanding the importance of age-appropriate activities that target specific developmental domains, such as tactile stimulation in this case, is essential for promoting optimal growth and sensory integration in infants. By engaging infants in appropriate activities, nurses and caregivers can support their overall development and well-being.

Correct Answer: C

Rationale: Rationale: The correct answer is C) She may need to begin taking them at age 6 months. Fluoride supplements are typically recommended for breastfed infants once they reach 6 months of age and are exclusively breastfed, as breast milk alone may not provide enough fluoride for optimal dental health. Option A) She needs to begin taking them now is incorrect because fluoride supplements are not usually recommended for infants under 6 months old. Option B) They are not needed if you drink fluoridated water is incorrect because the fluoride content in water alone may not be sufficient for infants' needs, especially for optimal dental health. Option D) She can have infant cereal mixed with fluoridated water instead of supplements is incorrect as infant cereals may not provide an adequate amount of fluoride, and it is not a recommended alternative to fluoride supplements. Educational Context: This question is crucial in pediatric nursing as it addresses the importance of fluoride supplementation in exclusively breastfed infants for proper dental health. Understanding the appropriate timing for starting fluoride supplements can prevent dental issues later in life, making it a critical aspect of pediatric nursing care.