A hypercoagulable state in nephrotic syndrome results from?

Correct Answer: C

Rationale: In nephrotic syndrome, a hypercoagulable state can occur due to changes in coagulation factor levels. This is because the loss of proteins, particularly antithrombin III and protein C, through the kidneys leads to decreased regulation of the coagulation cascade, resulting in an increased risk of thrombosis. Option A, hemodilution, is incorrect as it refers to the dilution of blood due to fluid overload, which can actually decrease the risk of thrombosis rather than increase it. Option B, decreased platelet number, is incorrect as thrombosis in nephrotic syndrome is not primarily due to platelet abnormalities but rather to changes in coagulation factors. Option D, decreased hepatic production of fibrinogen, is incorrect as fibrinogen levels are usually elevated in nephrotic syndrome due to increased hepatic synthesis in response to urinary losses. Understanding the pathophysiology of nephrotic syndrome and its effects on the coagulation system is crucial for nursing practice, especially when caring for pediatric patients who may be at higher risk for thrombotic complications. Nurses must be able to recognize the signs and symptoms of thrombosis in these patients and implement appropriate preventive measures and treatments to prevent complications.

Correct Answer: C

Rationale: The correct answer is C) He now mimics the gestures of his father. In the resolution of the Oedipal complex during the phallic stage of Freud's psychosexual development, a child typically identifies with the same-sex parent to resolve feelings of competition and jealousy towards the opposite-sex parent. By mimicking the gestures of his father, Kenneth is demonstrating identification with the same-sex parent, indicating that he has resolved his Oedipal conflict. Option A) He now assumes the role of his father is incorrect because at this stage, the child is not assuming the actual role of the parent but rather identifying with them. Option B) He now assumes the role of his mother is incorrect as the resolution involves identification with the same-sex parent. Option D) He now mimics the gestures of his mother is incorrect for the same reason. In an educational context, understanding Freud's psychosexual stages can provide insights into children's behavior and development. Recognizing how children navigate these stages can help caregivers and educators support them effectively through various developmental challenges.

Correct Answer: B

Rationale: The correct answer is B) Noisy eructations. Gino's presentation with severe vomiting, weight loss, epigastric pain, distention, and a palpable olive-size mass in the right upper quadrant is indicative of pyloric stenosis. Noisy eructations, known as "projectile vomiting," are a classic symptom of pyloric stenosis due to the forceful expulsion of gastric contents. This occurs because the hypertrophied pyloric muscle obstructs the passage of food from the stomach to the duodenum, leading to projectile vomiting. Excessive salivation (option A) is not typically associated with pyloric stenosis. Decreased frequency of stools (option C) is not a common symptom of pyloric stenosis and would not explain Gino's presentation. Fresh blood in the stool (option D) is also not a typical finding in pyloric stenosis. In an educational context, understanding the key clinical manifestations of pyloric stenosis is crucial for pediatric nurses preparing for the NCLEX exam. Recognizing the signs and symptoms of pyloric stenosis can aid in prompt diagnosis and intervention, ultimately improving patient outcomes. Studying specific pediatric conditions like pyloric stenosis helps nurses provide safe and effective care to pediatric patients.

Correct Answer: B

Rationale: The correct answer is B) ventricular septal defect, overriding the aorta, pulmonic stenosis, right ventricular hypertrophy. In Tetralogy of Fallot, these four defects are characteristic: a ventricular septal defect allows mixing of oxygenated and deoxygenated blood; overriding aorta causes blood from both ventricles to flow into the aorta; pulmonic stenosis restricts blood flow to the lungs; and right ventricular hypertrophy develops due to increased workload. Option A is incorrect as it describes defects associated with other conditions like aortic valve coarctation, pulmonic valve stenosis, and mitral valve stenosis not typically seen in Tetralogy of Fallot. Option C includes defects like tricuspid valve atresia, atrial septal defect, hypoplastic right ventricle, and PDA which are not part of Tetralogy of Fallot. Understanding these specific defects associated with Tetralogy of Fallot is crucial for nurses caring for pediatric patients with this condition. Knowing the pathophysiology helps in providing appropriate care, anticipating complications, and educating patients and families about the condition.

Correct Answer: E

Rationale: In this scenario, the correct answer is not provided in the options listed. However, the most appropriate technique to facilitate lipreading with a hearing-impaired child is to ensure good lighting. Adequate lighting is crucial for the child to clearly see the speaker's facial expressions and lip movements. This helps in enhancing the child's ability to understand the spoken words through lipreading. Speaking words in a loud tone (Option A) may distort lip movements, making it harder for the child to understand. Standing at a distance from the child (Option B) can also hinder the child's ability to see the speaker's lip movements clearly. Keeping sentences short (Option C) can be beneficial, but it is not as critical as ensuring good lighting and clear visibility of facial expressions. Using facial expressions while speaking (Option D) is indeed important as it aids in conveying emotions and context, making lipreading more effective. In an educational context, it is important for healthcare providers to be well-versed in communication techniques for individuals with different needs, such as hearing impairment. Understanding the nuances of lipreading and providing appropriate support can significantly improve the quality of care for these individuals. By implementing strategies like ensuring good lighting and using appropriate facial expressions, healthcare professionals can effectively communicate with hearing-impaired children and support their overall well-being.