All the following can cause metabolic acidosis with a high anion gap Except:

Correct Answer: C

Rationale: In pediatric nursing, understanding metabolic acidosis is crucial for providing effective care to children. The correct answer is option C) Renal tubular acidosis. Renal tubular acidosis is a condition where the kidneys are unable to excrete acid appropriately, leading to metabolic acidosis with a normal anion gap, not a high anion gap as seen in the other conditions. Option A) Diabetic ketoacidosis is a common cause of metabolic acidosis with a high anion gap in children with diabetes due to the accumulation of ketones. Option B) Salicylate poisoning can also lead to high anion gap metabolic acidosis by causing an increase in acid production. Option D) Renal failure can result in high anion gap metabolic acidosis due to the accumulation of acidic waste products that the kidneys are unable to excrete. Educationally, it is important for pediatric nurses to be able to differentiate between various causes of metabolic acidosis to provide timely and appropriate interventions. Understanding the underlying pathophysiology of each condition is essential for accurate assessment and management of pediatric patients presenting with metabolic acidosis. This knowledge helps nurses prioritize care and collaborate effectively with the healthcare team to improve patient outcomes.

Correct Answer: D

Rationale: In pediatric nursing, understanding the staging classifications of diseases like Hodgkin's lymphoma is crucial for effective patient care. In this case, the correct answer is D) Stage II-B. This staging is determined by the presence of enlarged lymph nodes on both sides of the diaphragm, which includes the right axillary lymph node and the large posterior cervical lymph node seen in the patient. Option A) Stage 1-A is incorrect because it involves only a single lymph node region. Option B) Stage 1-B is also incorrect as it involves the presence of additional symptoms beyond just lymph node involvement. Option C) Stage II-A is wrong as it does not account for the involvement of lymph nodes on both sides of the diaphragm. Educationally, this question highlights the importance of recognizing the specific criteria for staging Hodgkin's lymphoma in pediatric patients. Understanding the staging helps in determining the appropriate treatment plan and prognosis for the child. It emphasizes the need for nurses to be well-versed in oncology nursing principles to provide comprehensive care to pediatric oncology patients.

Correct Answer: D

Rationale: In pediatric nursing, understanding CNS leukemia is crucial as it is a life-threatening condition. The correct answer, D) None of the above, is right because CNS leukemia does not always have a bad prognosis, increased intracranial tension is a common symptom due to leukemic infiltrates, and relapse is indeed common in leukemia, including in the central nervous system. Option A, stating a bad prognosis, is often associated with CNS leukemia, but it is not always the case. Prognosis can vary based on factors such as subtype, response to treatment, and overall health status of the child. Option B is incorrect as increased intracranial tension is a hallmark sign of CNS leukemia due to the infiltration of leukemic cells into the central nervous system, leading to symptoms such as headaches, vomiting, and altered mental status. Option C, mentioning relapse is common, is actually true for CNS leukemia. Despite initial treatment success, relapse can occur, necessitating close monitoring and potential additional therapies. In an educational context, it is essential for pediatric nurses to have a comprehensive understanding of CNS leukemia to provide optimal care to affected children. Recognizing the signs and symptoms, understanding prognosis factors, and being prepared for potential relapse are vital aspects of managing this condition effectively. By grasping these concepts, nurses can play a crucial role in supporting not only the child but also their family through the challenging journey of dealing with CNS leukemia.

Correct Answer: A

Rationale: In the context of pediatric nursing, understanding different types of anemia is crucial for accurate assessment and intervention. In this case, the correct answer is A) Hereditary microspherocytosis because it is a hemolytic anemia characterized by spherocytes, not microcytes. This condition is inherited and not related to microcytic hypochromic anemia. Option B) Thalassemia is a form of microcytic hypochromic anemia characterized by defective globin chain synthesis. Option C) Iron deficiency is a common cause of microcytic hypochromic anemia due to inadequate iron for hemoglobin synthesis. Option D) Sideroblastic anemia is also a cause of microcytic hypochromic anemia due to impaired heme synthesis. Educationally, understanding the different causes of anemia is essential for nurses caring for pediatric patients. Recognizing the specific characteristics of each type of anemia allows for targeted interventions, such as iron supplementation for iron deficiency anemia. This knowledge also helps in differentiating between various types of anemia based on clinical presentations and laboratory findings, guiding appropriate treatment strategies.

Correct Answer: C

Rationale: In pediatric nursing, understanding developmental milestones is crucial for assessing a child's growth and well-being. The correct answer is C) 8 months for most infants to sit steadily unsupported. At around 8 months, infants typically have developed enough strength and balance to sit without support. Option A) 4 months is too early for most infants to sit steadily unsupported. At 4 months, infants are still developing their neck and core strength, which are essential for sitting independently. Option B) 6 months is a common milestone for infants to start sitting with support or propped up, but they may not be able to sit steadily without assistance at this age. Option D) 10 months is on the higher end of the typical range for infants to sit unsupported. By 10 months, most infants should have achieved this milestone, but it is not the most common age for this skill to emerge. Educationally, understanding the timeline of developmental milestones helps pediatric nurses monitor a child's progress, identify any delays or concerns early on, and provide appropriate interventions or referrals. It also informs caregivers about what to expect as their child grows, promoting parent education and involvement in their child's development.