A highly careful mother of a 10-month-old baby boy complains of inadequate weight gain due to refusal of spoon feeding. The LEAST helpful advice is to

Correct Answer: B

Rationale: In this scenario, the LEAST helpful advice is to offer a softer diet (Option B). This is because offering a softer diet does not address the underlying issue of refusal to spoon feed and inadequate weight gain. Respecting infant independence (Option A) is important for fostering autonomy and development. Using 2 spoons (Option C) can help involve the child in the feeding process, promoting positive feeding experiences. Introducing finger foods (Option D) can be a helpful strategy to encourage self-feeding and exploration of different textures, which can aid in improving weight gain. Educationally, understanding the developmental stage of infants is crucial in addressing feeding challenges. Providing appropriate strategies to support feeding skills and autonomy can help parents navigate these situations effectively. By choosing the least helpful option, we emphasize the importance of addressing the root cause of feeding issues rather than simply changing the texture of the food.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A: "My child is able to stand but is not yet taking steps independently." This statement raises a concern because by 18 months, a child should typically be able to walk independently. This delay in achieving a milestone could indicate a potential developmental delay that requires further evaluation by healthcare professionals. Option B, stating "My child has a vocabulary of approximately 15 words," is within the normal range for an 18-month-old and does not necessarily indicate a developmental delay. Option C, "My child is still sucking his thumb," is a common behavior in toddlers and is not typically associated with developmental delays. Option D, "My child seems to be quite wary of strangers," is also a common behavior in toddlers and does not necessarily indicate a developmental delay. From an educational standpoint, understanding age-appropriate developmental milestones is crucial for pediatric healthcare providers. Recognizing when a child is not meeting expected milestones can lead to early identification and intervention for developmental delays, which can significantly impact long-term outcomes for the child. This question highlights the importance of thorough assessment and referral for further evaluation when developmental concerns are identified.

Correct Answer: D

Rationale: In this scenario, the correct treatment option for the child with acute renal failure (ARF) who is edematous, has minimal urine output, and elevated potassium levels is the placement of a Tenckhoff catheter for peritoneal dialysis (Option D). Peritoneal dialysis is a crucial intervention in pediatric patients with ARF as it helps to remove excess fluid, correct electrolyte imbalances such as hyperkalemia, and eliminate waste products when the kidneys are not functioning effectively. This intervention is particularly beneficial in children as it provides a gentler form of renal replacement therapy compared to hemodialysis. Option A, additional rectal Kayexalate, is not the most appropriate choice in this situation as the child is not responding to oral Kayexalate, and rectal administration may not provide the rapid and effective reduction in potassium levels required in this critical condition. Intravenous furosemide (Option B) may exacerbate the child's fluid overload and electrolyte imbalances by promoting further diuresis without addressing the underlying cause of ARF. Endotracheal intubation and ventilatory assistance (Option C) are not indicated solely for the management of ARF with electrolyte imbalances. While respiratory distress is present in this case, addressing the renal failure and associated complications should take precedence. Educationally, understanding the rationale behind choosing peritoneal dialysis in pediatric patients with ARF is essential for nurses working in pediatric emergency settings. It highlights the importance of timely and appropriate interventions to manage critical conditions effectively and underscores the significance of considering renal replacement therapies in pediatric patients with renal failure.

Correct Answer: D

Rationale: In the post-operative care of a child with repair of bladder exstrophy, the most appropriate medication is Oxybutynin (Option D). Oxybutynin is a medication commonly used to treat bladder spasms by relaxing the bladder muscles, which is crucial after bladder surgery to prevent discomfort and promote healing. Lasix (Option A) and Mannitol (Option B) are diuretics used to increase urine output and reduce edema, which are not typically indicated in this scenario. Meperidine (Option C) is an opioid analgesic, which may be used for pain management but is not specifically targeted at bladder spasms or post-operative bladder care. Educationally, understanding the rationale behind medication choices in pediatric emergency nursing is vital for providing safe and effective care to pediatric patients. By knowing the appropriate medications for specific conditions, nurses can ensure optimal outcomes and prevent potential complications. It is essential for nurses to stay updated on evidence-based practices in pediatric emergency nursing to deliver high-quality care to children in various clinical settings.

Correct Answer: B

Rationale: In this case, the most likely cause of the infant's decline in growth pattern is option B) improper formula preparation. This is because the infant had a normal growth pattern till the introduction of juices and cereals at 6 months, which coincides with when the formula was introduced. Improper formula preparation can lead to inadequate nutrition, which can result in failure to thrive (FTT) in infants. Option A) failed breast feeding is less likely in this scenario as the infant had a normal growth pattern when breastfed exclusively for the first 4 months of life. Congenital syndromes (option C) and congenital infections (option D) would typically present with symptoms earlier in life and would not explain the sudden decline in growth pattern after the introduction of new foods. Educationally, this case highlights the importance of proper infant feeding practices and the potential consequences of improper formula preparation on a child's growth and development. It emphasizes the need for healthcare providers to educate caregivers on appropriate feeding techniques and the introduction of complementary foods to ensure optimal nutrition for infants.