All the following are diagnostic criteria for major depressive episode EXCEPT

Correct Answer: A

Rationale: In pediatric nursing, it is essential to have a clear understanding of major depressive episodes to provide optimal care for children and adolescents experiencing mental health issues. In this context, the correct answer, option A, which is "hypomanic episode," is not a diagnostic criterion for major depressive episodes. Depressed mood, loss of interest or pleasure, and significant weight loss are all diagnostic criteria for a major depressive episode according to the DSM-5 criteria used in psychiatric assessment. Depressed mood is a core symptom of depression, characterized by feelings of sadness, hopelessness, or irritability. Loss of interest or pleasure, known as anhedonia, is another key symptom indicating a major depressive episode. Significant weight loss is also a common physical manifestation of depression due to changes in appetite and eating habits. Understanding these diagnostic criteria is crucial for pediatric nurses to accurately assess, identify, and support children and adolescents with mental health concerns. By recognizing these symptoms, healthcare providers can initiate appropriate interventions, such as therapy, medication, or referrals to mental health specialists, to address the needs of young patients experiencing major depressive episodes. Therefore, in the context of pediatric nursing, being able to differentiate between the diagnostic criteria for major depressive episodes is vital for providing comprehensive care and support for young individuals struggling with mental health issues.

Correct Answer: A

Rationale: In pediatric nursing, it is crucial to understand the safety of medications for breastfeeding mothers and their infants. Psychotropic drugs are considered safe to use with caution during breastfeeding because they have limited transfer into breast milk and are generally well-tolerated by infants. Option A is correct because many psychotropic drugs, such as selective serotonin reuptake inhibitors (SSRIs), are commonly prescribed to breastfeeding mothers. They are preferred due to their safety profile during lactation. Option B, amphetamines, are not recommended during breastfeeding as they can be excreted into breast milk and may have adverse effects on the infant, including irritability and poor feeding. Option C, bromocriptine, is contraindicated during breastfeeding as it can suppress lactation and potentially harm the infant. Option D, methimazole, is also not recommended during breastfeeding due to the risk of transferring into breast milk and causing hypothyroidism in the infant. Educationally, understanding the safety profiles of medications during breastfeeding is essential for pediatric nurses to provide evidence-based care to mothers and infants. It ensures the well-being of both the mother and the baby while supporting successful breastfeeding practices. Nurses should be knowledgeable about which medications are safe to use during lactation to provide accurate information and guidance to breastfeeding mothers.

Correct Answer: C

Rationale: In a very low birthweight (VLBW) infant, the sudden onset of hypotension suggests bacterial sepsis (option C). This is because bacterial sepsis is a common and serious condition in premature infants, leading to systemic inflammatory response syndrome which can cause hypotension. Option A, pneumothorax, typically presents with respiratory distress, not isolated hypotension. Option B, necrotizing enterocolitis, often presents with abdominal distension, bloody stools, and signs of systemic illness rather than just hypotension. Option D, hypoglycemia, may cause symptoms like jitteriness or poor feeding but is less likely to cause sudden isolated hypotension without other signs. Educationally, understanding the differential diagnosis of a sudden onset of hypotension in a VLBW infant is crucial for pediatric nurses to provide prompt and appropriate care. Recognizing the signs of bacterial sepsis early can lead to timely interventions such as initiating antibiotics or fluid resuscitation, potentially preventing serious complications in these vulnerable infants.

Correct Answer: C

Rationale: In pediatric nursing, understanding respiratory distress syndrome (RDS) and its differentials is crucial for providing effective care. The correct answer, option C) total anomalous pulmonary venous return, can mimic RDS clinically and radiographically due to similar respiratory symptoms and chest X-ray findings. This anomaly leads to cyanosis and respiratory distress shortly after birth, resembling RDS presentation. Option A) persistent pulmonary hypertension typically presents with respiratory distress but is characterized by elevated pulmonary pressures, not the same radiographic findings as RDS. Option B) meconium aspiration syndrome presents with respiratory distress due to meconium in the airways, but its radiographic findings differ from RDS. Option D) lobar emphysema can cause respiratory distress but is characterized by localized hyperinflation rather than diffuse findings seen in RDS. Educationally, understanding these differentials enhances clinical reasoning skills in pediatric nursing. It reinforces the importance of thorough assessment, including history, clinical presentation, and radiographic findings, to differentiate between similar respiratory conditions in pediatric patients. This knowledge is vital for timely and accurate diagnosis and management, ultimately improving patient outcomes.

Correct Answer: D

Rationale: Rationale: The correct answer is D) usually occurs in preterm or near-term infants. Meconium aspiration syndrome (MAS) typically affects term or post-term infants, not preterm or near-term infants. This statement is incorrect as MAS is more commonly associated with infants born at or beyond full term. Option A is incorrect because MAS actually develops in approximately 10% of meconium-stained infants, not 5%. Option B is inaccurate as about 15-30% of infants with MAS require mechanical ventilation due to respiratory distress caused by meconium blocking the airways. Option C is sadly true, with a mortality rate of around 3-5% for infants with MAS. Educational Context: Understanding MAS is crucial for pediatric nurses as it is a serious respiratory condition that can lead to significant morbidity and mortality in newborns. Nurses must be able to identify the risk factors, signs, and symptoms of MAS to provide prompt and appropriate care. By knowing the correct information about MAS, nurses can intervene effectively and improve outcomes for these vulnerable patients.