A four-year-old patient has been diagnosed with leukemia. The patient's parents follow the Jehovah's Witness faith and inform the physician that they will not approve any type of blood transfusions. The pediatric nurse is aware that:

Correct Answer: C

Rationale: The correct answer is C) the patient can receive volume expanders. In the scenario described, the parents' religious beliefs prohibit blood transfusions. As a pediatric nurse, it is crucial to respect the parents' beliefs while also ensuring the best care for the child. Volume expanders are a suitable alternative to blood transfusions in cases where increasing the circulating blood volume is necessary. They help maintain blood pressure and tissue perfusion without violating the parents' wishes. Option A is incorrect because in an emergency situation where immediate intervention is required to save the child's life, parental consent may not be necessary, but it is important to respect the parents' beliefs whenever possible. Option B is incorrect as it imposes a specific restriction on blood donation sources, which may not align with the parents' preferences or beliefs. As an educator, it is essential to teach nursing students about the importance of cultural and religious sensitivity in providing care to pediatric patients and involving families in decision-making processes to the extent possible while ensuring patient safety and well-being.

Correct Answer: A

Rationale: Rationale: The correct answer is A) visual-motor coordination. At 22 months, children are in the early stages of development and are starting to explore and engage in activities that require coordination between their visual perception and motor skills. Building a tower involves looking at the blocks, planning how to stack them, and then using their hands to carry out the action. This process demonstrates the integration of visual information with physical movements, which is known as visual-motor coordination. Option B) using visual and motor skills in combination is similar to the correct answer, but it lacks the specificity of the term "coordination," which is crucial in understanding the complexity of the task for a toddler. Option C) gross and fine motor coordination is not entirely accurate in this context. While building a tower does involve both gross (large muscle movements) and fine (small muscle movements) motor skills, the key aspect being tested in this question is the coordination between visual input and motor output. Option D) symbolic thought is not relevant to the task of building a tower with blocks for a 22-month-old child. Symbolic thought typically develops later in childhood and involves the ability to understand and use symbols to represent objects or ideas. Educational Context: Understanding the developmental milestones and skills required at different ages is essential for pediatric nurses to provide appropriate care and support to children and their families. By recognizing the significance of visual-motor coordination in activities like building a tower, nurses can assess a child's developmental progress and intervene if there are any concerns or delays. This knowledge also informs nurses on how to engage children in play activities that promote their physical and cognitive development.

Correct Answer: B

Rationale: In pediatric nursing, understanding child development milestones is crucial for providing effective care. The question pertains to object permanence, a key concept in Piaget's theory of cognitive development. The correct answer is B) 9 months. At this age, infants develop object permanence, realizing that objects continue to exist even when out of sight. They actively search for hidden objects, demonstrating cognitive growth. Option A) 7 months is incorrect as infants at this age do not yet typically exhibit full object permanence. Option C) 11 months is also incorrect as by this age, most children have already developed object permanence skills. Option D) 13 months is incorrect as children typically master object permanence around 8-12 months, so at 13 months, they should have already achieved this milestone. Educationally, understanding developmental milestones helps nurses assess children's growth, plan interventions, and educate caregivers about age-appropriate behaviors. This knowledge is essential for providing holistic care that considers not only physical but also cognitive and emotional development in pediatric patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) behavioral insomnia of childhood. This condition is characterized by difficulty falling asleep and/or staying asleep. In the case of the 4-year-old boy, his refusal to go to bed and remaining active are indicative of behavioral insomnia. This type of insomnia is often linked to poor sleep habits, parental influence, or learned behavior. Option A) thyrotoxicosis is unlikely in this case as it is a condition involving an overactive thyroid gland, leading to symptoms such as weight loss, heat intolerance, and fatigue, rather than solely difficulty sleeping. Option B) ADHD (Attention-Deficit/Hyperactivity Disorder) can present with hyperactivity and impulsivity, but the primary issue is not related to difficulty falling asleep. Children with ADHD may have sleep problems, but the behavior described is more indicative of behavioral insomnia. Option D) sleep-onset association disorder is a condition where a child associates falling asleep with certain conditions or objects. While this could contribute to difficulty falling asleep, the scenario described is more aligned with behavioral insomnia where the child actively resists going to bed. Educationally, understanding common pediatric sleep disorders is crucial for healthcare providers working with children and families. Recognizing the signs and symptoms of different disorders helps in accurate diagnosis and appropriate intervention. Behavioral interventions and sleep hygiene practices are key in managing behavioral insomnia in children, emphasizing the importance of establishing healthy bedtime routines.

Correct Answer: D

Rationale: In this question, the correct answer is option D) nightmare. The rationale behind this is that nightmares are not considered parasomniac disorders. Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. Option A) sleepwalking, Option B) sleepterror, and Option C) confusional arousal are all examples of parasomniac disorders. Sleepwalking involves walking or performing other complex behaviors while asleep. Sleepterrors are episodes of intense fear, screaming, and flailing while still asleep. Confusional arousal is a sleep disorder characterized by partial awakening and appearing confused or disoriented. It is important for pediatric nurses to understand these distinctions in order to accurately assess and manage pediatric patients with sleep disorders. By recognizing the different types of parasomnias, nurses can provide appropriate education to families, implement safety measures, and collaborate with other healthcare professionals to develop comprehensive care plans for children experiencing these sleep disturbances.