A parent of a child with acute renal failure (ARF) asks why peritoneal dialysis was chosen instead of hemodialysis. Which is the best response?

Correct Answer: C

Rationale: In this scenario, the best response to the parent's question about choosing peritoneal dialysis over hemodialysis for their child with acute renal failure (ARF) is option C: "Peritoneal dialysis removes fluid at a slower, more controlled rate, which minimizes complications." The correct answer is right because peritoneal dialysis allows for a gradual removal of fluid and waste products from the body, which is particularly beneficial in pediatric patients with ARF. This slower and more controlled rate helps prevent rapid shifts in electrolytes and fluid balance, reducing the risk of complications such as hypotension or electrolyte imbalances. Option A is incorrect because hemodialysis can indeed be used in pediatrics, although peritoneal dialysis is often preferred in certain situations. Option B is incorrect as peritoneal dialysis, like any medical procedure, can have complications such as infection, catheter-related issues, or fluid imbalances. Option D is incorrect because hemodialysis is generally considered more efficient than peritoneal dialysis in terms of toxin removal and fluid management, but the choice between the two modalities depends on various factors including the patient's condition, age, and clinical needs. In an educational context, it is important for healthcare providers to understand the rationale behind choosing specific dialysis modalities for pediatric patients with ARF. By selecting the most appropriate method based on individual patient factors, healthcare teams can optimize outcomes and minimize risks associated with renal replacement therapy in this vulnerable population.

Correct Answer: A

Rationale: In the early stages of acute hepatitis, manifestations typically include nausea, vomiting, and generalized malaise, making option A the correct answer. This is because hepatitis causes inflammation of the liver, leading to these non-specific symptoms in the initial phase of the illness. Option B (Nausea, vomiting, and left-upper quadrant pain) is incorrect because left-upper quadrant pain is not a typical early symptom of acute hepatitis. The liver is located in the right-upper quadrant, so pain is more likely to be felt in that region. Option C (Malaise and jaundice only) is incorrect because jaundice usually appears later in the course of acute hepatitis once the liver is significantly affected. Malaise alone is also a non-specific symptom that can be present in various conditions. Option D (Jaundice only) is incorrect because jaundice is not typically the only symptom seen in the early stages of acute hepatitis. It usually develops as the disease progresses and liver function is further compromised. In an educational context, understanding the progression of symptoms in acute hepatitis is crucial for nurses caring for pediatric patients. Recognizing the early signs can lead to prompt diagnosis and intervention, improving outcomes for children with this condition. Nurses must be knowledgeable about the typical manifestations of hepatitis to provide appropriate care and support to pediatric patients and their families.

Correct Answer: B

Rationale: The correct answer is B) supracondylar region of the femur. Osteopenia is a common complication following spinal cord injury (SCI) due to decreased weight-bearing activity and hormonal changes, leading to bone mineral density loss. The supracondylar region of the femur is the most common site for fractures in individuals with osteopenia due to its susceptibility to fractures under conditions of decreased bone density and increased stress. Option A) distal tibia is less likely as the most common site for fractures in osteopenia following SCI compared to the femur. Option C) lumbosacral spine is less likely as it is more commonly associated with vertebral compression fractures in conditions like osteoporosis. Option D) proximal humerus is less likely as it is not as commonly affected by osteopenia-related fractures in SCI patients compared to weight-bearing bones like the femur. Educationally, understanding the specific sites of fractures in osteopenia post-SCI is crucial for nurses caring for these patients. Recognizing the common sites of fractures can aid in preventive measures, early detection, and appropriate management to prevent further complications and promote optimal patient outcomes.

Correct Answer: B

Rationale: The correct answer is B) mothers. Child sexual abuse is more commonly perpetrated by males, including fathers, family friends, and teachers. This is due to societal power dynamics and historical trends in reported cases. Fathers and family friends, as male figures in a child's life, may have easier access and influence over the child. Teachers, being in positions of authority, can also exploit their power. However, mothers are less frequently involved in perpetrating child sexual abuse due to various factors such as protective instincts, societal roles, and historical gender norms. In an educational context, it is crucial for healthcare providers and educators to understand the patterns and characteristics of child sexual abuse perpetrators to effectively identify and prevent such cases. By recognizing common perpetrators, professionals can develop targeted intervention strategies, educate families on prevention, and provide support to victims. Additionally, raising awareness about the prevalence and dynamics of child sexual abuse can help reduce stigma and encourage reporting and early intervention.

Correct Answer: C

Rationale: In the context of pediatric nursing and adoption, the least likely required investigation for the adoption of a 1-year-old girl is screening tests for sexually transmitted diseases (Option C). This is because sexually transmitted diseases are typically not a concern in children of this age group due to the mode of transmission and the child's developmental stage. Neonatal screening tests (Option A) are important to assess the child's health status and detect any congenital conditions that may require early intervention. Immunization history (Option B) is crucial to ensure that the child is up to date with vaccinations to prevent infectious diseases. Cognitive tests (Option D) may be needed to evaluate the child's developmental milestones and identify any delays that may require intervention. Educationally, understanding the rationale behind the least likely investigation helps pediatric nurses prioritize assessments based on the child's age, developmental stage, and specific needs. It underscores the importance of tailoring healthcare interventions to the individual needs of each child, promoting evidence-based and family-centered care in pediatric nursing practice.