A parent came to your clinic complaining that their 5-year-old boy had attacks of frightening with imagination of a snake crawling over him and he is acting as trying to remove it. You assessed the child and find no acute physical illness and he is cooperative and quite intelligent. Of the following, the MOST appropriate explanation for the child behavior is

Correct Answer: D

Rationale: In this scenario, the most appropriate explanation for the child's behavior is option D) night terror. Night terrors are common in children and typically occur during non-REM sleep. Children experiencing night terrors may appear awake but are actually in a state of partial arousal, often displaying intense fear and confusion. Option A) acute phobic hallucination is incorrect because phobic hallucinations involve irrational fears related to specific objects or situations, not the sensation of a snake crawling over the body. Option B) early sign of schizophrenia is also incorrect as schizophrenia typically presents in late adolescence or early adulthood, not in young children. Option C) delusional infestation is unrelated to the child's symptoms and refers to a psychiatric condition where individuals believe they are infested with parasites. Educationally, understanding common childhood sleep disturbances like night terrors is crucial for healthcare providers working with pediatric populations. Recognizing the difference between benign conditions like night terrors and more serious mental health disorders is essential for accurate assessment and appropriate management of pediatric patients.

Correct Answer: C

Rationale: In the neonatal period, vomiting is a common issue that can arise due to various reasons. In this scenario, the correct answer is option C) overfeeding. Neonates have small stomach capacities and immature gastrointestinal systems, making them more prone to vomiting if overfed. Overfeeding can overwhelm their digestive capacity, leading to regurgitation of milk. Option A) pyloric stenosis is a condition where the muscle at the opening between the stomach and the small intestine thickens, causing vomiting, but this typically presents a bit later in infancy, usually around 2-8 weeks of age. Option B) milk allergy can cause symptoms like vomiting, but it is less common in the neonatal period compared to overfeeding. Option D) an inborn error of metabolism usually presents with symptoms beyond just vomiting, such as failure to thrive, seizures, or metabolic crises, and is less likely to be the cause of isolated vomiting in the neonatal period. Understanding the reasons behind neonatal vomiting is crucial for healthcare providers working with infants to appropriately assess, diagnose, and manage their conditions. Overfeeding is a common issue that can be easily addressed through education on proper feeding techniques, feeding cues, and appropriate feeding volumes, helping to prevent unnecessary distress for both the infant and caregivers.

Correct Answer: B

Rationale: In the context of pediatric care and the use of CPAP (Continuous Positive Airway Pressure), it is crucial for nursing students preparing for the NCLEX exam to understand the rationale behind each option provided. Option B, "its indicated if oxygen saturation cannot be kept > 95%," is the correct answer because CPAP is actually indicated when oxygen saturation levels cannot be maintained above 90-92%. CPAP helps to improve oxygenation in patients by keeping the alveoli open, allowing for better gas exchange. When oxygen saturation levels drop below 95%, CPAP may be considered as a treatment option. Option A, "it prevents collapse of surfactant-deficient alveoli," is a true statement. CPAP helps to keep the alveoli open, preventing atelectasis and promoting better oxygen exchange. Option C, "it improves functional residual capacity (FRC)," is also true. CPAP helps to recruit collapsed alveoli and improve lung volume, thus increasing the functional residual capacity. Option D, "it reduces ventilatory needs," is incorrect. CPAP does not reduce ventilatory needs but rather supports the patient's respiratory efforts by providing a continuous positive pressure to keep the airways open. Understanding the indications and effects of CPAP in pediatric patients is vital for nursing students as they care for children with respiratory distress. By grasping the nuances of CPAP therapy, students can provide safe and effective care to pediatric patients in need of respiratory support.

Correct Answer: D

Rationale: In the context of diagnosing congenital diaphragmatic hernia (CDH) through prenatal ultrasonography, it is crucial to understand the significance of each finding to make an accurate diagnosis. The correct answer, "D) olighydramnios," is the exception among the options as it is not typically associated with CDH on prenatal ultrasonography. A) "chest mass" is a common finding in CDH due to the herniation of abdominal contents into the chest cavity, leading to a visible mass. B) "mediastinal shift" is often seen in CDH as abdominal contents herniate into the chest, causing displacement of mediastinal structures. C) "gastric bubble" can be visualized in the chest due to the presence of the stomach in an abnormal location in CDH cases. Understanding these findings is crucial for healthcare providers, especially pediatric nurses, as they play a vital role in caring for infants with CDH. Recognizing these ultrasound findings helps in early detection and appropriate management of CDH, which can significantly impact the outcomes for these infants. Nurses need to have a strong foundation in pediatric conditions to provide safe and effective care to this vulnerable population.

Correct Answer: A

Rationale: In the context of pediatric health, understanding the early ultrasonographic signs of hydrops is crucial for nurses preparing for the NCLEX exam. The correct answer is A) double-bowel wall sign (bowel edema). This sign is indicative of fetal hydrops, a serious condition characterized by abnormal fluid accumulation in two or more fetal compartments. Bowel edema is a specific finding on ultrasound that suggests the presence of hydrops. Option B) polyhydramnios refers to excessive amniotic fluid which can be seen in certain conditions but is not a specific early sign of hydrops. Option C) ascites, which is fluid accumulation in the abdomen, can be a consequence of hydrops but is not an early ultrasonographic sign. Option D) scalp edema is another potential clinical sign of hydrops but is not typically seen on ultrasound in the early stages. Educationally, understanding these distinctions is vital for nurses as they care for pediatric patients and pregnant women. Recognizing these early signs can lead to prompt intervention and improved outcomes. Nurses need to be able to differentiate between various ultrasound findings to provide accurate assessments and interventions, making this knowledge essential for pediatric nursing practice.