A search to determine the cause of jaundice should be made in all the following conditions EXCEPT

Correct Answer: C

Rationale: In pediatric nursing, understanding the causes of jaundice is crucial for early detection and appropriate management. In this question, option C is the correct answer because a serum bilirubin level of >12 mg/dL in a full-term infant is a normal physiological response within the first few days of life and does not necessarily indicate a pathological condition requiring further investigation. Option A is incorrect because jaundice appearing in the first 24-36 hours of life, known as physiological jaundice, is common and usually resolves without intervention. Option B is incorrect as a rising serum bilirubin level at a rate faster than 5 mg/dL/24 hours may indicate hemolysis or other pathological conditions that warrant further investigation. Option D is incorrect because a direct bilirubin fraction >1 mg/dL at any time may indicate liver pathology and requires further evaluation. Educationally, this question highlights the importance of differentiating between physiological and pathological jaundice in neonates. It reinforces the need for healthcare providers to understand normal variations in bilirubin levels in newborns and to only investigate further when specific criteria suggestive of underlying pathology are met, thus avoiding unnecessary interventions and parental anxiety.

Correct Answer: A

Rationale: The correct answer is A) Cytomegalovirus. Osteitis, which is inflammation of the bone, can be a feature of congenital cytomegalovirus infection in infants. Cytomegalovirus can be transmitted transplacentally from the mother to the fetus during pregnancy, leading to various manifestations including osteitis. Option B) Herpes simplex virus is incorrect because while it can cause neonatal herpes with central nervous system involvement, it is not typically associated with osteitis. Option C) Varicella-zoster virus is incorrect as it is known to cause chickenpox and shingles, but osteitis is not a common feature of these infections. Option D) Rubella is also incorrect because congenital rubella syndrome can lead to various abnormalities, but osteitis is not typically associated with rubella infection. In an educational context, understanding the manifestations of different transplacental infections is crucial for pediatric nurses to provide comprehensive care to infants. Recognizing the specific features of each infection helps in early diagnosis and appropriate management to improve outcomes for affected infants.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the factors that suggest hemolytic disease as a cause of jaundice in newborns is crucial for early identification and appropriate management. The correct answer, option D, "Significant decrease in hemoglobin," is not typically associated with hemolytic disease but rather indicates other conditions such as hemorrhage or iron deficiency anemia. Option A, "Bilirubin rise of >0.5 mg/dL/h," is indicative of hemolysis leading to an increased bilirubin production. Option B, "Reticulocytosis >5% at birth," suggests an increased rate of red blood cell production in response to hemolysis. Option C, "Onset of jaundice before 24 hours of age," is also consistent with hemolytic disease as early onset jaundice is a common feature. Educationally, this question highlights the importance of recognizing specific clinical indicators associated with different causes of jaundice in newborns. By understanding these factors, nurses can differentiate between hemolytic disease and other causes, enabling prompt interventions and improving patient outcomes. This knowledge is essential for pediatric nurses to provide comprehensive and effective care to newborns experiencing jaundice.

Correct Answer: D

Rationale: In this question from the Pediatric Nursing Review, the correct answer is D) above-average intelligence. This option carries a poor prognosis for nonepileptic seizures. The rationale behind this is that individuals with above-average intelligence may have a harder time accepting their diagnosis, leading to poorer outcomes in terms of treatment adherence and psychological adjustment. Option A) symptoms of paralysis and blindness, and Option B) presence of tremor are not indicative of a poor prognosis for nonepileptic seizures. These symptoms do not necessarily correlate with treatment outcomes or long-term effects on the patient's well-being. Option C) acute onset does not necessarily point towards a poor prognosis either; it may vary depending on the underlying cause and the individual's response to treatment. From an educational perspective, understanding the prognostic factors for nonepileptic seizures is crucial for nurses working with pediatric patients. Recognizing these factors can help in providing holistic care, tailored to the individual needs of each patient. It also emphasizes the importance of considering psychological and emotional factors in pediatric care, not just the physical symptoms.

Correct Answer: D

Rationale: In pediatric nursing, understanding the differences in how PTSD manifests in children compared to adults is crucial for providing effective care. In this case, the correct answer is D) exaggerated startle response. This symptom is more commonly seen in children with PTSD due to their developmental stage and heightened emotional reactivity. Children may exhibit a more pronounced startle response compared to adults, reflecting their vulnerability and difficulty in regulating emotions. Option A) difficulty falling or staying asleep is a common symptom in both children and adults with PTSD, making it less distinctive in children. Option B) outbursts of anger can be seen in both age groups, but they are not necessarily more prevalent in children than in adults. Option C) estrangement from others may occur in both children and adults with PTSD, so it is not a distinguishing feature for children specifically. Educationally, highlighting the differences in how PTSD symptoms present in children versus adults helps nurses tailor their assessments and interventions to meet the unique needs of pediatric patients. Recognizing the exaggerated startle response as a key indicator in children can guide nurses in providing appropriate support and interventions to address their specific emotional responses.