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: The correct answer is D) night terror. Night terrors are a type of sleep disorder that occurs during non-REM sleep and are more common in children. They often involve intense episodes of screaming, fear, and confusion. In this case, the child's symptoms of imagining a snake crawling over him and trying to remove it are consistent with the characteristics of night terrors. Option A) acute phobic hallucination is incorrect because phobic hallucinations are not typically associated with night terrors and do not explain the child's behavior during sleep. Option B) early sign of schizophrenia is incorrect as schizophrenia is a serious mental disorder that typically presents later in adolescence or early adulthood, and the child's symptoms are not indicative of schizophrenia. Option C) delusional infestation is also incorrect as this refers to a psychiatric disorder where individuals have a fixed, false belief of being infested with parasites, which does not align with the child's symptoms. In an educational context, understanding common pediatric sleep disorders like night terrors is crucial for healthcare providers working with children and families. Recognizing and differentiating between various sleep disturbances can help in providing appropriate support and guidance to parents and caregivers dealing with such issues.

Correct Answer: C

Rationale: In the neonatal period, vomiting is a common issue that can have various causes. In this scenario, the correct answer is C) overfeeding. Neonates have small stomach capacities and immature digestive systems, making them prone to vomiting if they are overfed. This can overwhelm their digestive system, leading to regurgitation of milk. Option A) pyloric stenosis is a condition that typically presents later in infancy with projectile vomiting and is not a common cause of vomiting in the neonatal period. Option B) milk allergy can cause symptoms like vomiting, but it usually presents with other symptoms such as rash, diarrhea, or irritability. Option D) an inborn error of metabolism would typically present with more systemic issues rather than isolated vomiting. In an educational context, understanding common causes of vomiting in neonates is crucial for healthcare professionals working with this population. Recognizing the signs and symptoms of overfeeding can help prevent complications and ensure appropriate feeding practices are followed to support optimal neonatal health and development.

Correct Answer: B

Rationale: In the context of pediatric care and respiratory support, understanding the use of CPAP (Continuous Positive Airway Pressure) is crucial. In this question, option B is the correct answer because CPAP is actually indicated when oxygen saturation cannot be maintained above 95%. Option A is incorrect because CPAP does indeed prevent the collapse of surfactant-deficient alveoli by providing a continuous pressure to keep the airways open. Option C is also incorrect as CPAP does improve the functional residual capacity (FRC) by keeping the alveoli open and preventing collapse. Option D is incorrect as well because CPAP actually increases ventilatory needs by improving oxygenation and reducing the work of breathing, which can lead to increased ventilation needs. Educationally, understanding the indications and effects of CPAP in pediatric patients is vital for nurses and healthcare providers working in pediatric settings. It helps in providing appropriate respiratory support and optimizing patient care for children with respiratory distress or failure.

Correct Answer: D

Rationale: The correct answer is D) oligohydramnios. Oligohydramnios is not typically a specific finding associated with congenital diaphragmatic hernia (CDH) on prenatal ultrasonography. A) Chest mass and B) mediastinal shift are commonly seen in CDH cases due to the herniated abdominal contents compressing the developing lung. These findings are key indicators that suggest the presence of CDH. C) Gastric bubble may also be visualized in CDH cases due to the displacement of abdominal organs into the chest cavity, leading to the stomach being seen above the diaphragm. In an educational context, understanding the prenatal diagnosis of CDH is crucial for healthcare professionals caring for neonates with this condition. Recognizing the characteristic ultrasonographic findings can aid in early detection and appropriate management of CDH, which can significantly impact the outcomes for affected infants. It is important to differentiate between common and uncommon findings to provide optimal care and support for both the infant and the family.

Correct Answer: A

Rationale: In the context of pediatric care, understanding 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 bowel edema, which is a key feature of hydrops fetalis. Bowel edema is one of the initial ultrasonographic findings in the development of hydrops, making it a significant early marker for this condition. Option B) polyhydramnios is excessive amniotic fluid surrounding the fetus and is not specific to hydrops. While it can be present in some cases of hydrops, it is not an early sign. Option C) ascites refers to fluid accumulation in the abdomen and is a late sign of hydrops, not an early ultrasonographic finding. Option D) scalp edema is also a late sign of hydrops and is not typically one of the early ultrasonographic signs seen in fetal hydrops. Understanding these distinctions is essential for nurses caring for pediatric patients, as it helps in early identification and intervention for conditions like hydrops fetalis. By recognizing the early ultrasonographic signs, healthcare providers can initiate timely and appropriate management to improve outcomes for both the fetus and the mother.