A normal platelet count with prolonged bleeding time is seen in:

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Von Willebrand disease. Von Willebrand disease is a common inherited bleeding disorder characterized by a deficiency or dysfunction of von Willebrand factor, which plays a crucial role in platelet adhesion and clot formation. This leads to prolonged bleeding time despite having a normal platelet count. Option A) Hemophilia A is incorrect because it is a deficiency in factor VIII, a clotting factor, which leads to excessive bleeding but does not affect platelet count. Option C) Leukemia is incorrect as it is a cancer of the blood cells where platelet count is usually low due to bone marrow infiltration and suppression. Option D) Hypersplenism is incorrect as it is a condition where the spleen removes platelets from circulation, leading to thrombocytopenia, not a prolonged bleeding time with a normal platelet count. Educationally, understanding these distinctions is crucial for pediatric nurses to accurately assess and manage pediatric patients with bleeding disorders. Recognizing the specific characteristics of each disorder enables appropriate interventions and prevents potential complications. It is essential for nurses to know the pathophysiology behind these conditions to provide safe and effective care to pediatric patients with bleeding disorders.

Correct Answer: A

Rationale: The correct answer is A) Terminal part of small intestine. Tuberculosis can affect various parts of the body, including the gastrointestinal tract. In pediatric patients, the terminal part of the small intestine is commonly affected by gastrointestinal tuberculosis. This area is susceptible to infection due to its rich blood supply and lymphatic drainage. Option B) Terminal part of esophagus is incorrect because esophageal tuberculosis is rare compared to involvement of the small intestine in tuberculosis cases. Option C) Terminal part of large intestine is incorrect as tuberculosis more commonly affects the small intestine rather than the large intestine in the pediatric population. Option D) Pylorus is incorrect as tuberculosis primarily affects the small intestine and not specifically the pylorus. In an educational context, understanding the common manifestations of tuberculosis in different parts of the body is crucial for healthcare providers, especially pediatric nurses. Knowing the typical sites of tuberculosis infection in the gastrointestinal tract can aid in early recognition, diagnosis, and appropriate management of the disease in pediatric patients.

Correct Answer: C

Rationale: In this question, the correct answer is C) Severe coarctation of the aorta. The presence of a severe coarctation of the aorta in a newborn can lead to heart failure due to the obstruction of blood flow from the left ventricle to the body. This results in increased workload on the heart, leading to heart failure. Option A) Large VSD (Ventricular Septal Defect) and option B) Large ASD (Atrial Septal Defect) are not typically associated with heart failure in newborns. While these defects can cause issues with blood flow and oxygenation, they do not directly lead to heart failure in the same way that a severe coarctation of the aorta can. Option D) Severe Tetralogy of Fallot is a cyanotic congenital heart defect characterized by four specific heart abnormalities. While Tetralogy of Fallot can lead to cyanosis and hypoxia, it is not typically associated with heart failure in newborns unless there are severe complications present. Understanding the association between specific congenital heart defects and their potential complications is crucial in pediatric nursing. Recognizing the signs and symptoms of heart failure in newborns with severe coarctation of the aorta can help nurses provide timely and appropriate interventions to manage the condition effectively.

Correct Answer: D

Rationale: In this question, the correct answer is D) Acute rheumatic fever recurrence. The Jones criteria are a set of guidelines used to help diagnose acute rheumatic fever, a condition that can follow an untreated streptococcal infection. One of the major criteria in the Jones criteria is the history of acute rheumatic fever or its recurrence. Therefore, adherence to the Jones criteria is necessary to diagnose acute rheumatic fever recurrence accurately. Now, let's analyze why the other options are incorrect: A) Chorea: While chorea is one of the major manifestations of acute rheumatic fever, it is not specifically mentioned in the Jones criteria for diagnosis. B) Indolent carditis: Carditis is indeed a major criterion in the Jones criteria, but the term "indolent" does not align with the acute nature of rheumatic fever. C) Subcutaneous nodules: Subcutaneous nodules are also a major criterion in the Jones criteria, but they are not directly linked to the need for adherence specifically in diagnosing acute rheumatic fever recurrence. Educational Context: Understanding the Jones criteria is crucial for healthcare professionals, especially those working with pediatric patients. By knowing the criteria and the significance of each component, nurses can accurately assess and diagnose acute rheumatic fever in children. This knowledge helps in providing timely and appropriate treatment to prevent complications and long-term sequelae associated with the condition. Regular review and application of the Jones criteria in clinical practice can improve patient outcomes and reduce the burden of rheumatic heart disease in pediatric populations.

Correct Answer: D

Rationale: Innocent heart murmurs are benign murmurs commonly heard in children with structurally normal hearts. These murmurs are typically soft, systolic, and do not signify any underlying heart disease. Therefore, children with innocent murmurs do not require any specific interventions or restrictions. Option A, restriction of exercise, is incorrect because children with innocent murmurs do not need to limit physical activity as these murmurs do not pose a risk during exercise. Option B, antibiotic prophylaxis against infective endocarditis, is unnecessary in children with innocent murmurs as these murmurs are not associated with an increased risk of infective endocarditis. Option C, an initial echocardiographic tracing to rule out structural heart disease, is also not indicated for innocent murmurs. Innocent murmurs are diagnosed based on characteristic auscultation findings and a thorough clinical evaluation, without the need for further imaging studies in the absence of concerning symptoms or signs of heart disease. Educationally, understanding the characteristics and management of innocent heart murmurs is crucial for healthcare providers working with pediatric populations. By differentiating innocent murmurs from pathological murmurs, healthcare providers can avoid unnecessary interventions, reduce parental anxiety, and provide appropriate care for children with innocent murmurs. Regular auscultation and clinical assessment are key components of pediatric care to identify and appropriately manage innocent murmurs.