A term newborn presents with jaundice and a total bilirubin level of 20 mg/dL. Which treatment is most appropriate?

Correct Answer: C

Rationale: In this scenario, the most appropriate treatment for a term newborn with jaundice and a total bilirubin level of 20 mg/dL is phototherapy (Option C). Phototherapy is the primary treatment for neonatal jaundice as it helps convert bilirubin into a form that can be easily excreted by the body. Option A, intravenous fluids, would not directly address the elevated bilirubin levels in the newborn, so it is not the most appropriate treatment. Option B, exchange transfusion, is a more invasive procedure and is usually reserved for severe cases of jaundice that do not respond to phototherapy. Option D, oral phenobarbital, is not the first-line treatment for neonatal jaundice and is typically used in specific cases where phototherapy is ineffective. In an educational context, understanding the appropriate management of neonatal jaundice is crucial for pediatric nurses. Phototherapy is a common intervention that nurses will encounter in their practice, and knowing when to initiate it can prevent complications associated with untreated hyperbilirubinemia. Nurses must be aware of the different treatment options available and their indications to provide safe and effective care for newborns with jaundice.

Correct Answer: C

Rationale: In the context of bronchial asthma, the correct answer is C) Chest examination must reveal bilateral wheezes. This statement is false because wheezes in bronchial asthma are typically heard bilaterally and not unilaterally. Wheezes are caused by the turbulent airflow through narrowed airways due to inflammation and constriction, which is a hallmark of asthma. Option A is true as bronchial asthma presents with episodic symptoms of airflow obstruction, leading to wheezing, coughing, and shortness of breath during asthma attacks. Option B is correct because the symptoms of bronchial asthma can be reversed with the administration of β2 agonists, which act as bronchodilators to open up the airways and improve airflow. Option D is also true as inhaled corticosteroids are considered the cornerstone of long-term therapy for bronchial asthma. They work by reducing airway inflammation, which helps in preventing asthma attacks and controlling symptoms over time. Educationally, understanding the characteristics of bronchial asthma, including its symptoms, treatment options, and diagnostic findings like wheezes, is crucial for pediatric nurses caring for children with asthma. Recognizing the correct and incorrect statements about asthma helps nurses provide appropriate care, educate patients and families, and effectively manage asthma in pediatric patients.

Correct Answer: A

Rationale: The correct answer is A) It is audible during the inspiratory phase of breathing. A pleural friction rub is a specific type of lung sound that is typically heard during both the inspiratory and expiratory phases of breathing. This sound is caused by the rubbing together of inflamed pleural surfaces and is usually described as a grating or creaking sound. Therefore, the fact that it is audible during both phases of breathing makes option A incorrect. Option B) It may be associated with pain is a common characteristic of a pleural friction rub. Patients experiencing this lung sound may report chest pain that worsens with breathing or coughing due to the underlying inflammation. Option C) It is unaltered by coughing is incorrect because coughing can sometimes temporarily change or mask the sound of a pleural friction rub. Coughing can disrupt the rubbing of the inflamed pleural surfaces, leading to a temporary reduction in the sound heard. Option D) Better heard with the chest piece of the stethoscope tightly placed over the chest wall is incorrect because a pleural friction rub is usually best heard with the diaphragm of the stethoscope rather than the chest piece. Placing the stethoscope too tightly on the chest wall may dampen the sound rather than enhance it. Educationally, understanding lung sounds like pleural friction rubs is crucial for pediatric nurses as they assess and monitor respiratory conditions in children. Recognizing the characteristics of different lung sounds can help nurses make accurate assessments, provide appropriate interventions, and communicate effectively with healthcare providers about a child's respiratory status.

Correct Answer: D

Rationale: In Basic Life Support (BLS), it is crucial to immobilize the cervical spine if there is a possibility of a spinal cord injury, making option D the correct answer. Immobilizing the cervical spine helps prevent further damage to the spinal cord in case of an injury. This step is essential in emergency situations to ensure the safety and well-being of the patient. Option A, to get the 'sniffing' position, is incorrect as it refers to positioning the patient's head and neck to open the airway during intubation, not for cervical spine immobilization. Option B, to fix oral airway, is also incorrect as it pertains to maintaining a clear airway and is not specific to cervical spine immobilization. Option C, to clear the oropharynx, is important for airway management but does not address the need for cervical spine immobilization in the context of spinal cord injury. In an educational context, understanding the importance of cervical spine immobilization in BLS is critical for healthcare providers, especially those working in pediatric care. Proper training and knowledge in BLS techniques, including spinal immobilization, can make a significant difference in the outcomes of pediatric patients in emergency situations. Healthcare professionals must be well-versed in these techniques to provide effective and safe care to pediatric patients.

Correct Answer: A

Rationale: In this question, the incorrect statement regarding corticosteroids in allergy is option A: "The mechanism of action is not known." The correct answer is that the mechanism of action of corticosteroids is indeed known. Corticosteroids work by reducing inflammation and suppressing the immune response. They do this by inhibiting the production of inflammatory mediators such as prostaglandins and leukotrienes, as well as by suppressing the activity of immune cells involved in allergic reactions. Option B states that corticosteroids are lymphopenic, which is correct. Corticosteroids can cause a decrease in the number of lymphocytes in the blood, which can impact the immune response. Option C is also incorrect. Corticosteroids do decrease the synthesis of prostaglandins, which are inflammatory mediators involved in the allergic response. Option D is the incorrect statement about corticosteroids in allergy. Long-term usage of corticosteroids can indeed suppress linear growth in children, making this statement accurate. In an educational context, it is crucial for pediatric nurses to have a comprehensive understanding of the effects and mechanisms of action of medications commonly used in pediatric allergy management. Understanding the correct and incorrect statements about corticosteroids in allergies can help nurses make informed decisions when caring for pediatric patients with allergic conditions. It also highlights the importance of monitoring children on long-term corticosteroid therapy for potential growth issues.