A breastfeeding mother asks the postpartum nurse if any supplementation is necessary once her breast milk comes in. What is the nurse's most appropriate response?

Correct Answer: C

Rationale: The correct answer is C because recent studies have shown that breast milk is low in vitamin D, and supplementation with 400 IU is recommended. This is important for infants who are not exposed to the sun or have dark skin, as they are at risk for insufficient vitamin D. While a well-balanced diet is important for the mother's health, it does not address the need for vitamin D supplementation in breastfed infants. Asking about the mother's concerns or abilities does not provide the necessary information about vitamin D supplementation.

Correct Answer: A

Rationale: Turning the infant every 2 hours can increase the effectiveness of phototherapy in reducing indirect bilirubin levels. This intervention helps expose all parts of the skin to the phototherapy. The other options either do not directly impact bilirubin reduction or may hinder the effectiveness of phototherapy.

Correct Answer: A

Rationale: The correct answer is A) simple pulmonary eosinophilia. Simple pulmonary eosinophilia, also known as Loeffler syndrome, is the most common etiology of pulmonary infiltrates with eosinophilia (PIE). This condition is characterized by transient pulmonary infiltrates, peripheral blood eosinophilia, and a self-limited course. It is often triggered by parasitic infections or allergic reactions. Option B) acute eosinophilic pneumonia presents with acute respiratory failure, diffuse alveolar infiltrates, and marked eosinophilia in the lungs. This condition is more severe and acute compared to PIE. Option C) chronic eosinophilic pneumonia is characterized by chronic cough, fever, and peripheral blood eosinophilia. It typically presents with more persistent symptoms and infiltrates on imaging studies. Option D) allergic bronchopulmonary aspergillosis is a hypersensitivity reaction to Aspergillus antigens. It is characterized by bronchial obstruction, mucus plugging, and central bronchiectasis, rather than the transient pulmonary infiltrates seen in PIE. Understanding the different etiologies of pulmonary infiltrates with eosinophilia is crucial for pediatric nurses conducting respiratory assessments. Recognizing the distinguishing features of each condition helps in accurate diagnosis and appropriate management. It is important to differentiate between these conditions as treatment approaches vary significantly.

Correct Answer: B

Rationale: In pediatric respiratory assessment, understanding common presenting features of cystic fibrosis is crucial for early detection and intervention. The MOST common presenting feature of cystic fibrosis is persistent respiratory symptoms, making option B the correct answer. Children with cystic fibrosis often present with chronic cough, wheezing, and recurrent respiratory infections due to thick, sticky mucus in the lungs. Option A, failure to thrive, is a common finding in cystic fibrosis but may not be the most common presenting feature. Children with cystic fibrosis have difficulty absorbing nutrients due to pancreatic insufficiency, leading to poor weight gain and growth. Option C, abnormal stools, specifically greasy and foul-smelling stools, are characteristic of cystic fibrosis due to malabsorption issues. While this is a common feature, it typically follows respiratory symptoms in presentation. Option D, meconium ileus, is a neonatal presentation of cystic fibrosis where the newborn's first bowel movement is blocked. While meconium ileus is associated with cystic fibrosis, it is not the most common presenting feature seen in older children. Educationally, understanding the common presenting features of cystic fibrosis helps nurses and healthcare providers recognize the condition early, initiate appropriate diagnostic testing, and provide timely interventions to improve outcomes for pediatric patients. Early identification and management of cystic fibrosis can significantly impact a child's quality of life and long-term prognosis.

Correct Answer: D

Rationale: The correct answer is D) metastatic lesions. In pediatric patients, pulmonary malignancies are extremely rare compared to adults. When they do occur, the most common form is metastatic lesions, which are cancers that have spread from another part of the body to the lungs. This can happen in cases of advanced cancers from other organs like neuroblastoma, Wilms tumor, or osteosarcoma. Option A) bronchial carcinoid is a rare type of lung tumor that is more commonly seen in adults. Option B) adenoid cystic carcinoma and C) mucoepidermoid carcinoma are both types of salivary gland tumors and are not typically seen in the lungs of pediatric patients. In an educational context, it is important for nurses to be aware of the rare occurrence of pulmonary malignancies in children and to understand that metastatic lesions are more common than primary lung tumors in this population. This knowledge can help nurses in early detection, appropriate referrals, and providing comprehensive care to pediatric patients with suspected or diagnosed pulmonary malignancies.