A -g infant of a diabetic mother experiences seizures on the first day of life Laboratory studies revealed blood glucose of 8 mg/dL and calcium of mg/dL Thereafter, calcium gluconate ( %), mL/kg, was given repeatedly without affecting the frequency of seizures The most appropriate step to manage this infant's condition is to

Correct Answer: D

Rationale: The correct answer is D) Administer magnesium sulfate. In this scenario, the infant is experiencing seizures with low blood glucose levels despite repeated administration of calcium gluconate. This suggests the seizures are likely due to hypocalcemia secondary to maternal diabetes rather than solely hypoglycemia. Magnesium sulfate is the appropriate treatment for hypocalcemia-related seizures in neonates. Choice A) Administering glucose would only address hypoglycemia, not the underlying cause of seizures in this case. Choice B) Administering pyridoxine is used for seizures associated with pyridoxine-dependent epilepsy, which is not indicated here. Choice C) Administering calcium would not be effective as repeated calcium gluconate administration did not resolve the seizures, indicating the issue is likely not solely related to calcium deficiency. Educationally, this question reinforces the importance of considering potential causes of seizures in neonates beyond hypoglycemia, such as hypocalcemia in this case. It highlights the need for a systematic approach to diagnosing and treating neonatal seizures to ensure appropriate management and optimal outcomes.

Correct Answer: A

Rationale: In this question, the correct answer is A) It is normal behavior in young children. Truancy is defined as the act of staying away from school without permission. In young children, truancy is not considered normal behavior as they are typically under the supervision of parents or caregivers who ensure they attend school regularly. Option B) It represents disorganization within the home is incorrect because truancy is more about the child's behavior rather than the organization within the home. Option C) It may reflect underlying child abuse is incorrect because while truancy can sometimes be a sign of other issues, such as abuse, it is not always the case. Option D) Adolescents may be at risk of substance abuse is incorrect because while truancy can be a risk factor for substance abuse, it is not the only factor. In an educational context, understanding the reasons behind truancy is important for pediatric nurses as they work with children and families. Recognizing the signs of truancy and its potential underlying causes can help nurses intervene early and provide appropriate support and resources to families in need. By understanding that truancy is not normal behavior in young children, nurses can better advocate for the well-being of their pediatric patients.

Correct Answer: C

Rationale: The most appropriate next action for a 24-month-old child diagnosed with ASD is to conduct a lead level test (Option C). Lead exposure can exacerbate symptoms of ASD and impact neurodevelopment. Identifying and addressing lead exposure early is crucial for the child's overall health and well-being. Physical examination (Option A) is a routine part of healthcare but may not provide specific information related to ASD or lead exposure in this case. Hearing tests (Option B) are important for children with ASD, but lead exposure should be ruled out first due to its immediate health risks. A Woods lamp (Option D) is used to detect fungal infections like tinea capitis and is not relevant in this scenario. Educationally, it is essential for pediatric nurses to understand the potential impacts of environmental factors like lead exposure on children with developmental disorders such as ASD. By prioritizing lead level testing in this case, nurses can ensure a comprehensive approach to the child's care and advocate for interventions to mitigate any harmful effects on their health.

Correct Answer: D

Rationale: In pediatric nursing, understanding stereotypic movements is crucial for assessing a child's development and behavior. In this question, the correct answer is D) head banging. Head banging is not a recognized stereotypic movement in children and may indicate other underlying issues such as pain, discomfort, or frustration. A) Hand shaking, B) eye blinking, and C) body rocking are all examples of recognized stereotypic movements in children. Hand shaking and eye blinking are common self-soothing behaviors, while body rocking is often seen in children with developmental disorders such as autism. Educationally, knowing the difference between stereotypic movements helps nurses differentiate normal behaviors from potential concerns. By recognizing these behaviors, nurses can provide appropriate interventions and support for children and their families. It is essential for pediatric nurses to have a comprehensive understanding of child development and behavior to deliver high-quality care.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) it indicates a potential for future lying behavior. This is incorrect because frequent lying behavior in a 3-year-old child is developmentally normal and not necessarily an indicator of future lying tendencies. Children at this age are often exploring their imagination, testing boundaries, and learning about cause and effect. Lying at this stage is more about experimentation and not fully understanding the concept of lying as deceit. Option A) it is a method of playing with language is correct because young children often engage in imaginative play and storytelling, which can involve exaggerations or fabrications that are not meant to deceive. Option B) it is a part of their magical thinking is also correct as young children may blend reality with fantasy and have difficulty distinguishing between the two. This can lead to exaggerated stories or statements that are not intended to deceive but rather reflect their vivid imagination. Option D) it is an approach to avoid unwanted confrontation with adults is correct as well because young children may lie to avoid punishment or conflict, not necessarily with the intention of deceiving but more as a way to navigate challenging situations. Educationally, it is crucial for parents and caregivers to understand the developmental stages of children and how they explore communication and problem-solving strategies. By recognizing that lying in young children is often a normal part of cognitive and social development, adults can respond with patience, guidance, and appropriate discipline techniques that focus on teaching honesty and integrity over punitive measures. This understanding can help foster a trusting relationship between adults and children, promoting healthy development and ethical behavior in the long term.