A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The nurse should recommend that the infant be given:

Correct Answer: C

Rationale: The correct answer is C. For infants younger than 1 year, the American Academy of Pediatrics recommends the use of breast milk or iron-fortified formula. If breastfeeding is discontinued before 1 year, it is important to switch to a commercial iron-fortified formula to ensure the infant is receiving all the necessary nutrients for growth and development.

Correct Answer: D

Rationale: The correct answer is D) surgery may be indicated in severe or persistent cases. Pubertal gynecomastia is the development of benign breast tissue in males during puberty. It is essential to understand that while gynecomastia is a common occurrence in adolescents, it usually resolves on its own within 6 months to 2 years without the need for intervention. However, in severe or persistent cases where there is significant physical or psychological distress for the individual, surgical intervention may be recommended to remove the excess breast tissue. Option A is incorrect because pubertal gynecomastia occurs in up to 70% of normal adolescent males, not 20%. Option B is incorrect as the typical onset of pubertal gynecomastia is around the ages of 10 to 14 years, not between 7 and 9 years. Option C is incorrect because while most cases of pubertal gynecomastia regress within a couple of years, it may take longer than 6 months for complete resolution in some cases. In an educational context, understanding the nuances of pubertal gynecomastia is crucial for pediatric clinical nurse specialists to provide appropriate care and support to adolescents experiencing this condition. Recognizing when surgical intervention may be necessary and guiding patients and their families through the decision-making process are essential aspects of holistic care in pediatric nursing.

Correct Answer: A

Rationale: In the context of pediatric mechanical ventilation, understanding the different modes is crucial for a Clinical Nurse Specialist. The correct answer, A) pressure support ventilation (PSV), is not a controlled mode of mechanical ventilation. PSV is actually a spontaneous mode where the patient initiates the breath and the ventilator provides support. Conventional mechanical ventilation (CMV) is a controlled mode where the ventilator completely controls the timing and amount of breaths delivered. Intermittent mechanical ventilation (IMV) is a mode where a set number of breaths are delivered per minute, but the patient can also initiate additional breaths. Synchronized intermittent mechanical ventilation (SIMV) is a mode where the ventilator delivers a set number of breaths, but also synchronizes with the patient's own breaths. Understanding these distinctions is vital for nurses caring for pediatric patients on mechanical ventilation to ensure appropriate settings are selected based on the patient's condition and needs. Mastery of these concepts enhances patient safety and outcomes.

Correct Answer: C

Rationale: The correct answer to the question is C) alcohol. In adolescents in the USA, alcohol consumption is the most common factor that increases the likelihood of drowning. This is due to the fact that alcohol impairs judgment, coordination, and reaction time, making individuals more vulnerable to accidents, including drowning. Option A) epilepsy is not a direct risk factor for drowning in adolescents unless a seizure occurs while swimming, which is less common. Option B) long QT syndrome is a cardiac condition that can lead to sudden cardiac arrest but is not directly linked to an increased risk of drowning in adolescents. Option D) myocarditis is an inflammation of the heart muscle and, while it can impact cardiac function, it is not as common a risk factor for drowning in adolescents as alcohol consumption. Educationally, it is crucial for pediatric clinical nurse specialists to be aware of the common risk factors for drowning in adolescents to provide adequate preventive education to both adolescents and their caregivers. Understanding the impact of alcohol on drowning risk can help healthcare providers target interventions and education efforts effectively.

Correct Answer: B

Rationale: In the case of a preterm infant with a patent ductus arteriosus (PDA), the primary treatment is typically indomethacin (Option B). Indomethacin is a nonsteroidal anti-inflammatory drug that helps to close the PDA by inhibiting prostaglandin synthesis. This medication is effective in promoting ductal closure in many preterm infants with PDA. Antibiotics (Option A) are not the primary treatment for PDA. PDA is a cardiac condition related to the persistence of a fetal connection between the aorta and pulmonary artery. Antibiotics do not address the underlying issue of the open ductus arteriosus. Corticosteroids (Option C) are not the primary treatment for PDA either. While corticosteroids have anti-inflammatory properties, they are not typically used as a first-line treatment for closing a PDA in preterm infants. Surgery (Option D) is considered when medical management such as indomethacin fails to close the PDA or if the infant's condition deteriorates. However, surgery is usually reserved for cases where pharmacological interventions have been ineffective. Educationally, understanding the appropriate treatment for PDA in preterm infants is crucial for pediatric clinical nurse specialists. It is essential to be knowledgeable about the pharmacological options available, their mechanisms of action, and the criteria for selecting the most appropriate treatment based on the infant's condition. This knowledge helps ensure optimal care and outcomes for these vulnerable patients.