A term baby of an uncomplicated pregnancy is born limp, cyanotic, and apneic after a difficult vaginal delivery Possible considerations for this state include all of the following EXCEPT

Correct Answer: D

Rationale: The correct answer is D) Administration of local anesthetic into the fetal scalp. In this scenario, the baby is presenting with signs of perinatal depression, which can be caused by various factors such as birth asphyxia. Administration of local anesthetic into the fetal scalp, while a common practice during instrumental vaginal deliveries, would not directly cause the baby to present with symptoms of perinatal depression. Option A) Prolapsed umbilical cord could lead to fetal hypoxia and subsequent perinatal depression due to compromised blood flow to the baby. Option B) Central nervous system trauma during delivery can also result in perinatal depression. Option C) Administration of morphine to the mother can lead to respiratory depression in the newborn if the drug crosses the placenta. Educationally, understanding the causes of perinatal depression and its management is crucial for pediatric nurses to provide timely and appropriate interventions to stabilize a newborn's condition. It highlights the importance of recognizing potential risk factors during labor and delivery and being prepared to address them promptly to ensure optimal outcomes for both the mother and the newborn.

Correct Answer: B

Rationale: In pediatric nursing, understanding common behaviors associated with psychiatric illnesses is essential for providing comprehensive care to children. The correct answer, option B) Sudden overwhelming worries, is not true in many psychiatric illnesses because it specifically refers to symptoms of anxiety disorders rather than a broad range of psychiatric conditions. Option A) Eating very little is a common behavior seen in psychiatric illnesses such as depression or anorexia nervosa. Children may lose their appetite or have disordered eating patterns due to their mental health condition. Option C) Feeling sad or withdrawn is characteristic of mood disorders like depression or adjustment disorders. Children experiencing these conditions may exhibit withdrawal from activities they once enjoyed and have persistent feelings of sadness. Option D) Throwing up can be a symptom of various psychiatric illnesses, including eating disorders like bulimia nervosa or somatic symptom disorders where physical symptoms are manifested due to psychological distress. Educationally, it is vital for nursing students to differentiate between behaviors specific to certain psychiatric illnesses to accurately assess, diagnose, and plan interventions for pediatric patients. Understanding these distinctions helps in providing individualized care tailored to the child's needs and promoting their mental health and well-being.

Correct Answer: D

Rationale: In pediatric nursing, understanding school refusal is crucial as it can impact a child's well-being and academic success. The FALSE statement among the options is D) Somatic symptoms are common. This is incorrect because somatic symptoms are actually common in children with school refusal. These symptoms can manifest as physical complaints like headaches or stomach aches to avoid going to school. Option A is true as school refusal often overlaps with other conditions like anxiety disorders. Younger children commonly experience separation anxiety, making option B correct. Option C is also accurate as older children may have underlying obsessive-compulsive disorders contributing to school refusal. Educationally, knowing these distinctions helps nurses identify and support children experiencing school refusal effectively. By recognizing the false statement, nurses can provide appropriate interventions and collaborate with other healthcare professionals to address the physical and emotional needs of the child, promoting their overall well-being and academic success.

Correct Answer: C

Rationale: In this scenario, the most appropriate referral for a 13-year-old adolescent presenting with fatigue, low blood pressure, and hypokalemia would be option C: Referral to the hospital for investigations. This choice is correct because the symptoms described could indicate a serious underlying medical condition that requires immediate attention and thorough investigation by healthcare professionals in a hospital setting. Referring the adolescent to a psychiatrist (option A) is not the most appropriate initial step because the symptoms are physical in nature and suggest a potential medical issue rather than a primary psychiatric concern. While mental health should always be considered in a comprehensive assessment, in this case, the priority is to address the physical symptoms. Referring to a dietician (option B) could be beneficial in cases where poor nutrition is contributing to the symptoms. However, given the severity of the symptoms described (fatigue, low blood pressure, and hypokalemia), immediate medical evaluation and intervention are necessary before addressing dietary concerns. Scheduling an outpatient visit to a psychiatrist (option D) may delay the necessary medical investigations and interventions that are required urgently in this case. Outpatient psychiatric visits are more suitable for ongoing mental health management rather than addressing acute physical symptoms. In an educational context, it is essential for healthcare providers, especially those in pediatric nursing, to be able to recognize concerning symptoms in children and adolescents and understand the appropriate steps for referral and intervention. Prompt and accurate decision-making can have a significant impact on patient outcomes, especially in cases where timely medical attention is crucial.

Correct Answer: B

Rationale: The correct answer is B) 20%. In pediatric nursing, it is crucial to understand the prevalence of mental illnesses in childhood to provide appropriate care and support. Research indicates that approximately 20% of children will experience a mental health disorder at least once during their childhood. This statistic underscores the importance of early detection, intervention, and holistic care for children with mental health issues. Option A) 10% is incorrect because the prevalence of mental illnesses in children is higher than this figure. Option C) 30% and Option D) 40% are also incorrect as they overestimate the percentage, which could lead to misconceptions and inappropriate allocation of resources in healthcare settings. Educationally, understanding the prevalence of mental health disorders in children is vital for nurses and healthcare providers working with pediatric populations. By being aware of this statistic, nurses can advocate for mental health screenings, promote mental wellness, and ensure appropriate support systems are in place for children in need. This knowledge enhances the quality of care provided to pediatric patients and contributes to better health outcomes.