A preterm neonate is being treated for respiratory distress syndrome. Which of the following is the primary benefit of surfactant therapy?

Correct Answer: B

Rationale: In the context of nursing interventions for pediatric respiratory distress, the primary benefit of surfactant therapy in treating respiratory distress syndrome in preterm neonates is reducing surface tension in the alveoli, which is option B. Surfactant is a substance naturally produced in the lungs that helps reduce surface tension in the alveoli, preventing their collapse during exhalation and promoting lung compliance. In preterm neonates with respiratory distress syndrome, there is a deficiency of surfactant, leading to alveolar collapse and difficulty in breathing. By administering exogenous surfactant, healthcare providers can improve lung function by reducing surface tension, thereby preventing atelectasis and improving gas exchange. Option A, promoting lung growth, is not the primary benefit of surfactant therapy. While surfactant does support lung development by preventing alveolar collapse and promoting expansion, its primary function in this context is to reduce surface tension. Option C, improving oxygen uptake in the placenta, is incorrect as surfactant therapy directly impacts lung function and alveolar stability, not oxygen uptake in the placenta. Option D, decreasing blood pressure in the lungs, is also incorrect. Surfactant therapy primarily focuses on improving lung function and oxygenation by reducing surface tension in the alveoli, rather than directly affecting blood pressure in the lungs. Understanding the primary benefits and mechanisms of surfactant therapy in treating respiratory distress syndrome is crucial for nursing interventions in pediatric patients, especially preterm neonates, to provide effective and evidence-based care to improve respiratory outcomes.

Correct Answer: B

Rationale: In pediatric nursing, therapeutic play is a powerful tool to help children cope with medical procedures, express emotions, and promote healing. For a 4-year-old, imaginative play is crucial for emotional and cognitive development. Dress-up clothes best promote imaginative play among the options provided. Here's why: 1. **Correct Answer (B - Dress-up clothes):** Dress-up clothes allow a child to role-play different characters, scenarios, and professions, fostering creativity and imagination. Through this type of play, a child can express feelings, explore social roles, and make sense of their experiences in a safe and enjoyable way. 2. **Why Others Are Wrong:** - **A) Large blocks:** While blocks are great for building and fine motor skills, they do not specifically promote imaginative play as effectively as dress-up clothes. - **C) Wooden puzzle:** Puzzles are beneficial for problem-solving and cognitive skills but do not offer the same imaginative play opportunities as dress-up clothes. - **D) Big wheels:** While riding toys like big wheels can be fun and promote physical activity, they do not directly support imaginative play or emotional expression like dress-up clothes. 3. **Educational Context:** Understanding the developmental needs of children is essential in pediatric nursing. By providing appropriate toys for therapeutic play, nurses can support children in coping with stress, anxiety, and medical procedures. Encouraging imaginative play through tools like dress-up clothes can enhance a child's emotional well-being and overall hospital experience.

Correct Answer: A

Rationale: The correct answer is A) This is probably the only concern he has about his body. So don't worry about it or the time he spends on it. This remark would be least helpful as it dismisses the boy's feelings and concerns about his acne and grooming habits. It invalidates his experiences and could potentially hinder open communication. Option B) provides important context about how teenagers may be self-conscious about their appearance, fostering understanding and empathy. Option C) opens the door for the boy to express his feelings, promoting a supportive and therapeutic conversation. Option D) acknowledges the boy's efforts in skincare and invites him to share more about his routine, encouraging engagement and trust. In an educational context, it is crucial for nurses to approach adolescent patients with sensitivity and respect, acknowledging their concerns and feelings. By fostering open communication and showing empathy, nurses can build trust and rapport with young patients, leading to better health outcomes and patient satisfaction. It is important to validate the experiences of adolescents and create a safe space for discussion during healthcare interactions.

Correct Answer: A

Rationale: In this scenario, the most likely cause of a sudden drop in oxygen saturation in a neonate receiving mechanical ventilation is option A) Pneumothorax. A pneumothorax occurs when air leaks into the space between the lung and chest wall, leading to lung collapse. In a neonate on mechanical ventilation, this can rapidly decrease oxygen levels due to impaired lung expansion and gas exchange. Option B) Hypovolemia refers to low blood volume and would not directly cause a sudden drop in oxygen saturation in this context. Option C) Acidosis, an increase in acidity in the blood, can impact oxygen delivery but typically would not cause a sudden drop in saturation. Option D) Sepsis, a systemic infection, may lead to oxygen desaturation but is less likely to cause a sudden drop compared to a pneumothorax in a ventilated neonate. Educationally, understanding the causes of sudden oxygen desaturation in neonates on mechanical ventilation is crucial for nurses caring for these vulnerable patients. Recognizing and promptly addressing pneumothorax is essential to prevent serious complications. This knowledge ensures timely interventions and optimal outcomes for neonates in respiratory distress.

Correct Answer: A

Rationale: In premature neonates, caffeine administration is primarily aimed at treating apnea of prematurity. Apnea, a common issue in preterm infants, is characterized by pauses in breathing for more than 20 seconds. Caffeine helps stimulate the respiratory center in the brain, leading to increased respiratory drive and decreased episodes of apnea. Option A is correct because caffeine is a respiratory stimulant that helps reduce the frequency and severity of apnea episodes, improving the infant's oxygenation and reducing the need for interventions like positive pressure ventilation. Option B, promoting lung maturation, is incorrect because caffeine does not directly influence lung development. Lung maturation in premature infants is primarily supported by antenatal steroids and appropriate respiratory support. Option C, improving feeding tolerance, is incorrect as caffeine does not have a direct effect on feeding tolerance. Feeding intolerance in premature infants is often related to gastrointestinal immaturity and needs to be managed separately. Option D, reducing the risk of infection, is also incorrect as caffeine does not play a role in infection prevention. Infection control in neonates is achieved through proper hygiene practices, aseptic techniques, and appropriate antibiotic therapy when indicated. Educationally, understanding the rationale behind administering caffeine to premature neonates is crucial for nurses caring for these vulnerable populations. It highlights the importance of respiratory support in preterm infants and the specific pharmacological interventions used to manage common complications like apnea of prematurity. This knowledge equips healthcare providers to deliver safe and effective care to neonates in respiratory distress, ultimately improving outcomes for these fragile patients.