All the following are diagnostic criteria for major depressive episode EXCEPT

Correct Answer: A

Rationale: The correct answer is A) hypomanic episode. In diagnosing a major depressive episode according to the DSM-5 criteria, the presence of a hypomanic episode would actually indicate a different mood disorder, such as bipolar disorder, rather than major depressive disorder. B) Depressed mood is a key diagnostic criterion for major depressive episode, characterized by feelings of sadness, emptiness, or irritability. C) Loss of interest or pleasure, known as anhedonia, is another hallmark symptom of major depressive episode, where individuals lose interest in activities they once enjoyed. D) Significant weight loss is also a common symptom seen in major depressive episodes, along with changes in appetite, either increase or decrease. In an educational context, understanding the diagnostic criteria for mood disorders is crucial for nurses working with pediatric patients. Recognizing these symptoms can help in early identification, appropriate referral, and intervention to support the mental health of children and adolescents. It is important for nurses to be able to differentiate between different mood disorders to provide optimal care and support to their pediatric patients.

Correct Answer: A

Rationale: In pediatric nursing, it is crucial to understand the safety considerations when administering drugs to breastfeeding mothers. The correct answer, psychotropic drugs (Option A), can be given with caution to breastfeeding mothers due to their relatively low transfer into breast milk and established safety profiles in lactation. Psychotropic drugs such as selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to nursing mothers with minimal adverse effects on the infant. Amphetamines (Option B) are not recommended during breastfeeding due to their potential for significant transfer into breast milk, leading to adverse effects on the infant's central nervous system and potential for stimulation. Bromocriptine (Option C) is contraindicated in breastfeeding mothers as it has been associated with severe adverse effects in infants, including respiratory distress and seizures. Methimazole (Option D) is also not recommended during breastfeeding as it can accumulate in the infant's thyroid gland, leading to potential hypothyroidism. Educationally, understanding the compatibility of medications with breastfeeding is essential for pediatric nurses to provide safe and effective care to both the mother and the infant. It is crucial to assess the risks and benefits of medications, consider alternative treatment options, and consult with healthcare providers to ensure the well-being of the breastfeeding dyad. This knowledge empowers nurses to advocate for evidence-based care and promote maternal and infant health during the breastfeeding period.

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 can lead to systemic inflammatory response syndrome (SIRS) which can result in hypotension. Sepsis is a serious condition in infants that requires prompt recognition and treatment to prevent complications. Option A, pneumothorax, typically presents with respiratory distress rather than hypotension. Option B, necrotizing enterocolitis, may present with abdominal distension and bloody stools but is less likely to cause sudden hypotension. Option D, hypoglycemia, can cause symptoms such as lethargy and poor feeding but is less likely to be the primary cause of sudden hypotension in this scenario. Educationally, it is crucial for pediatric nurses to understand the different conditions that can present in VLBW infants and recognize the signs and symptoms of each. This knowledge helps in early identification, appropriate interventions, and prevention of adverse outcomes in these vulnerable patients. Understanding the specific clinical manifestations of various conditions is essential for providing safe and effective care to neonates in the pediatric setting.

Correct Answer: C

Rationale: In this question, the correct answer is C) total anomalous pulmonary venous return (TAPVR). This condition can mimic Respiratory Distress Syndrome (RDS) both clinically and radiographically. TAPVR is a congenital heart defect where the pulmonary veins do not connect normally to the left atrium. This results in oxygenated blood from the lungs returning to the right side of the heart instead of the left side. This can lead to severe hypoxemia and respiratory distress in newborns, mimicking the symptoms of RDS. Option A) persistent pulmonary hypertension usually presents with signs of right heart failure and cyanosis rather than mimicking RDS. Option B) meconium aspiration syndrome presents with respiratory distress due to meconium in the lungs, which is different from the pathophysiology of RDS. Option D) lobar emphysema would show radiographic findings of hyperinflation of a lobe of the lung, which is distinct from the findings in RDS or TAPVR. Educationally, understanding the differential diagnosis of conditions that mimic each other is crucial in pediatric nursing. Recognizing these similarities and differences can guide appropriate diagnostic and treatment strategies, leading to better patient outcomes. This knowledge helps nurses provide accurate assessments and interventions for infants presenting with respiratory distress, ensuring prompt and effective care.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding meconium aspiration syndrome (MAS) is crucial for providing effective care to infants. The correct answer, D, is that MAS usually occurs in preterm or near-term infants. This is because meconium passage in utero typically happens in post-term infants. Therefore, MAS is less common in full-term infants. Option A is incorrect because MAS develops in about 5-10% of meconium-stained infants, not just 5%. Option B is inaccurate as only about 10-15% of infants with MAS require mechanical ventilation, not 30%. Option C states that 3-5% of infants die from MAS, which is true, highlighting the potential severity of the condition. Educationally, this question emphasizes the importance of recognizing MAS risk factors and outcomes. It underscores the need for nurses to provide prompt and appropriate care for infants at risk of MAS, including monitoring and support for respiratory distress. Understanding MAS helps nurses deliver evidence-based care and advocate for the best outcomes for pediatric patients.