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: In this scenario, the correct answer is C) the patient can receive volume expanders. This is because Jehovah's Witnesses do not accept blood transfusions due to religious beliefs, but they do accept other blood products and treatments that do not involve direct blood transfusion. Volume expanders, such as saline solutions, can be used to help maintain blood volume and circulation in the patient without contradicting the parents' wishes. Option A is incorrect because in an emergency, obtaining parental approval for medical interventions is still essential, even if it may delay treatment. Option B is incorrect as Jehovah's Witnesses typically do not distinguish between blood from family members and others when it comes to transfusions. It is important for pediatric nurses to respect and accommodate the religious beliefs of patients and families while ensuring that appropriate alternative treatments are provided to meet the patient's medical needs. This case highlights the significance of cultural competence and ethical considerations in pediatric nursing practice.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) visual-motor coordination. At 22 months of age, a child is typically in the stage of early toddlerhood. Building a tower involves the child utilizing both visual perception and motor skills to stack blocks or objects on top of each other. Visual-motor coordination refers to the ability to process visual information and use it to coordinate a physical response, such as reaching, grasping, or stacking. Option B) using visual and motor skills in combination is closely related to the correct answer, but it lacks the specificity of visual-motor coordination, which is the precise skill required for tower building. Option C) gross and fine motor coordination is not directly related to the task of building a tower, as it involves more complex movements that are not as precise as required for stacking blocks. Option D) symbolic thought is not relevant to this particular task as it pertains to the child's ability to understand symbols and represent objects with words or mental images. In an educational context, understanding the developmental milestones and appropriate activities for each age group is crucial for pediatric nurses. By recognizing the specific skills involved in tasks like tower building, nurses can assess a child's developmental progress and provide appropriate interventions or support if needed. Encouraging activities that promote visual-motor coordination can help foster a child's physical and cognitive development during this critical stage of early childhood.

Correct Answer: B

Rationale: The correct answer is B) 9 months. This question pertains to Piaget's theory of cognitive development, specifically the sensorimotor stage. At around 8-12 months, infants develop object permanence, which is the understanding that objects continue to exist even when they are out of sight. When a child searches for a hidden object, it indicates they have achieved object permanence, which typically occurs around 9 months of age. Option A) 7 months is incorrect because infants at this age have not fully developed object permanence. They are still in the earlier stages of sensorimotor development where they may lose interest in hidden objects once they are out of sight. Option C) 11 months and Option D) 13 months are incorrect as they fall outside the typical age range for achieving object permanence. By 11-12 months, most infants have already developed object permanence and would not continue searching for a hidden object once it is out of sight. Understanding Piaget's stages of cognitive development is crucial for pediatric nurses as it helps them assess a child's developmental progress and tailor interventions accordingly. Knowing the age-appropriate behaviors and milestones allows nurses to provide effective care and support for pediatric patients and their families.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) behavioral insomnia of childhood. Behavioral insomnia of childhood is a common sleep problem in young children where they resist going to bed, exhibit difficulty falling asleep, or have trouble staying asleep. The 4-year-old boy's behavior of refusing to go to bed and remaining active aligns with the characteristics of this condition. Understanding this helps identify the root cause of the behavior, allowing for appropriate interventions and management strategies. Option A) Thyrotoxicosis is unlikely in this case as it typically presents with symptoms related to the thyroid gland's overactivity, such as weight loss, increased appetite, and irritability, rather than just bedtime resistance and hyperactivity. Option B) ADHD could present with hyperactivity and difficulty in settling down, but in this case, the behavior is specifically related to bedtime, making behavioral insomnia a more fitting explanation. Option D) Sleep-onset association disorder involves needing a specific condition to fall asleep, such as needing a parent present. While it could lead to bedtime resistance, the boy's behavior of remaining active is more indicative of behavioral insomnia of childhood. Educationally, understanding common pediatric sleep disorders is crucial for healthcare providers working with children and their families. Identifying the underlying causes of sleep disturbances in children is essential for providing appropriate care and support to promote healthy sleep habits and overall well-being. By recognizing the signs and symptoms of different sleep disorders, healthcare professionals can offer tailored interventions to address the specific needs of each child and family.

Correct Answer: D

Rationale: In pediatric nursing, understanding sleep disorders is crucial for providing optimal care to children. The correct answer is D) nightmare because nightmares are not classified as 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. Sleepwalking (A), sleep terror (B), and confusional arousal (C) are all examples of parasomniac disorders. Sleepwalking involves walking or performing other complex behaviors while still asleep. Sleep terror, also known as night terrors, involves intense fear, screaming, and thrashing while still in a state of deep sleep. Confusional arousal is a sleep disorder that involves partial arousal during sleep, leading to confusion and disorientation. Educationally, it is important for nursing students to differentiate between various sleep disorders, including parasomnias, to accurately assess, diagnose, and intervene in pediatric patients' sleep-related issues. Understanding the nuances of each disorder helps in providing appropriate education and support to families dealing with these conditions. This knowledge is essential for promoting healthy sleep patterns and overall well-being in pediatric populations.