A 7 -g, 6-week’s-gestational-age white male is born after hours of premature rupture of the amniotic membranes The Apgar scores are and He immediately experiences respiratory distress and cyanosis requiring endotracheal intubation and mechanical ventilation with % oxygen Vital signs are temperature 7°C, heart rate 95, and mean blood pressure of mm Hg Laboratory tests reveal a white blood cell count of 5 and 59, platelets The next most appropriate treatment for this child is to administer

Correct Answer: B

Rationale: In this scenario, the most appropriate treatment for the newborn is to administer intravenous ampicillin and gentamicin (Option B). This treatment is indicated for suspected sepsis in neonates, as the infant presents with signs of infection such as respiratory distress, low temperature, and abnormal white blood cell count. Ampicillin covers for common pathogens like Group B Streptococcus, while gentamicin covers for Gram-negative bacteria. Prompt initiation of antibiotics is crucial in newborns to prevent serious complications from sepsis. Option A, surfactant by aerosol, is not the most appropriate choice in this case as the infant's presentation is more indicative of a potential infection rather than a respiratory issue requiring surfactant. Option C, intravenous steroids, is not the correct choice as steroids are not indicated in this scenario and may not address the underlying infection. Option D, intravenous acyclovir, is also incorrect as acyclovir is used to treat viral infections like herpes, which is not the primary concern in this case. Educationally, it is important for healthcare providers, especially pediatric nurses, to understand the rationale behind choosing appropriate treatments for newborns in different clinical scenarios. Understanding the signs and symptoms of neonatal sepsis, as well as the appropriate antibiotics to initiate, is crucial in providing effective and timely care to newborns in need. This case highlights the importance of considering sepsis as a differential diagnosis in newborns presenting with respiratory distress and other signs of infection.

Correct Answer: B

Rationale: Polycythemia is a condition characterized by an elevated red blood cell count. The correct answer, option B, "Intrauterine growth retardation," is not associated with polycythemia. In fact, polycythemia is more commonly linked with large-for-gestational-age infants due to increased blood volume. Option A, "Hyperviscosity," is associated with polycythemia as the increased number of red blood cells can lead to thicker blood consistency. Option D, "Twin-twin transfusion syndrome," is also related to polycythemia, as it involves an unequal blood flow between twins during pregnancy, potentially causing polycythemia in one twin. In an educational context, understanding the associations of polycythemia is crucial for pediatric nurses as they care for infants who may be affected by this condition. Recognizing the signs and symptoms of polycythemia and understanding its potential complications can aid in providing appropriate care and interventions for affected infants.

Correct Answer: D

Rationale: Rumination disorder is characterized by the repeated regurgitation and re-chewing of food, which leads to weight loss, malnutrition, and other health issues. The false statement in this question is option D: "It can resolve spontaneously." The correct answer is D because rumination disorder typically does not resolve spontaneously. It requires intervention and treatment by healthcare professionals, including pediatric nurses, to address the underlying causes and provide support to the child and their family. Option A, "It is only seen in infants," is incorrect because rumination disorder can occur in both infants and older children. It is not limited to a specific age group. Option B, "It runs a chronic course," is incorrect because rumination disorder can be successfully treated with early identification and intervention. It does not necessarily have to run a chronic course if addressed promptly. Option C, "It results from neglect," is incorrect because rumination disorder is a complex condition with various potential causes, including medical, psychological, and environmental factors. While neglect could be a contributing factor in some cases, it is not the sole cause of rumination disorder. In an educational context, it is important for pediatric nurses to understand the nuances of rumination disorder to provide comprehensive care to patients. By knowing the accurate information about the disorder, nurses can effectively assess, intervene, and support children and families affected by rumination disorder. Early recognition and appropriate treatment can improve outcomes and quality of life for children with this condition.

Correct Answer: A

Rationale: Breath-holding spells are a common phenomenon in pediatric populations, especially in toddlers and preschool-aged children. The best explanation for breath-holding spells being a manifestation of iron deficiency anemia (Option A) is due to the fact that these spells are often associated with anemia, and correcting the anemia can lead to a reduction or resolution of the spells. Iron deficiency can lead to decreased oxygen carrying capacity in the blood, which can trigger these spells in susceptible children. Option B, stating that breath-holding spells are a type of seizure, is incorrect. While breath-holding spells can sometimes resemble seizures due to the temporary loss of consciousness, they are not caused by abnormal electrical activity in the brain like seizures are. Option C, describing breath-holding spells as expressed by a brief tonic movement, is also incorrect. Breath-holding spells are characterized by a child holding their breath in response to a triggering event, not by tonic movements. Option D, claiming that breath-holding spells resolve by age 5, is not entirely accurate. While many children do outgrow these spells by age 5, some may continue to experience them beyond this age. It is not a definitive timeline for resolution. In an educational context, understanding the underlying causes of breath-holding spells, such as iron deficiency anemia, is crucial for pediatric nurses. By recognizing the connection between anemia and these spells, nurses can provide appropriate interventions such as iron supplementation and education for parents on how to manage and prevent these episodes. This knowledge enables nurses to offer comprehensive care to pediatric patients experiencing breath-holding spells.

Correct Answer: A

Rationale: The correct answer is A) Diffuse increase in brain size. In autistic spectrum disorders, one of the most consistent structural brain findings is an enlargement of the brain, particularly in early childhood. This increase in brain size is often seen in regions associated with language and social behaviors. Research suggests that this abnormal brain growth may contribute to the development of autistic symptoms. Option B) Focal atrophy is not a typical finding in autistic spectrum disorders. Atrophy implies a loss of brain tissue, which is not a characteristic feature of autism. Option C) White matter changes are not a consistent structural finding in autistic spectrum disorders. While some studies have reported alterations in white matter integrity, it is not the most prevalent or consistent finding. Option D) Gray matter degenerative changes are also not a common structural finding in autism. Degenerative changes suggest a progressive loss of gray matter volume, which is not a hallmark feature of autistic spectrum disorders. Educationally, understanding the structural brain findings in autistic spectrum disorders is crucial for healthcare professionals working with children with autism. This knowledge can help in early detection, intervention, and personalized treatment planning to support children with autism in reaching their full potential. It also highlights the importance of ongoing research to further understand the neurological basis of autism and develop targeted interventions.