An adolescent patient with chronic asthma, who has been hospitalized several times during the winter with severe asthmatic exacerbations, confides, 'I wish I could stay here in the hospital because every time I go home, I get sick again!' What is the pediatric nurse's best response?

Correct Answer: A

Rationale: The correct answer is A) Let's talk about preventing and managing your asthma on a daily basis at home. This response is the best because it acknowledges the adolescent's concerns, shows empathy, and shifts the focus to empowering the patient to take control of their asthma management. By discussing prevention strategies and daily management techniques, the nurse can help the patient feel more confident in managing their condition outside of the hospital setting. Option B is incorrect because it bypasses directly addressing the adolescent's feelings and needs by immediately involving the parents. While parental involvement is essential, the immediate need is to address the adolescent's emotional state and empower them. Option C is incorrect because it does not address the underlying issue of helping the patient manage their asthma effectively at home. Prolonged hospital stays are not always the best solution and can disrupt the patient's daily life and routine. In an educational context, it is crucial for pediatric nurses to recognize and address the emotional well-being of adolescent patients with chronic conditions like asthma. By providing support, education, and tools for self-management, nurses can help adolescents feel more in control of their health and reduce the likelihood of hospital readmissions. Empowering patients to manage their conditions independently is key to improving their quality of life and health outcomes.

Correct Answer: D

Rationale: In this question, the correct answer is D) gives a heavy meal within an hour of bedtime. The basic principle of healthy sleep hygiene is to promote behaviors and habits that support a restful and adequate sleep. Eating a heavy meal close to bedtime can lead to discomfort, indigestion, and disrupted sleep patterns. It is important to avoid heavy meals and instead opt for light, easily digestible snacks if needed before bedtime. Option A) setting a routine is a key aspect of promoting healthy sleep habits as it helps regulate the body's internal clock and signals when it's time to wind down for sleep. Option B) avoiding stimulating activities like playing computer games is important as these activities can interfere with the body's natural ability to relax and prepare for sleep. Option C) ensuring that a child spends time outside every day is also beneficial for sleep hygiene as exposure to natural light helps regulate the body's circadian rhythm and promotes better sleep patterns. In an educational context, understanding the principles of healthy sleep hygiene is crucial for caregivers, parents, and healthcare providers working with pediatric populations. By promoting these practices, we can support children in developing good sleep habits that are essential for their physical health, emotional well-being, cognitive development, and overall quality of life. It is important to educate families on the importance of a bedtime routine, limiting stimulating activities before bed, and making healthy choices regarding meals and snacks close to bedtime to ensure children get the restorative sleep they need for optimal growth and development.

Correct Answer: B

Rationale: In pediatric practice, autism screening is a crucial component of early childhood developmental assessments. The correct answer, option B (18 to 24 months), is based on current recommendations from the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). At 18 to 24 months, children undergo critical developmental milestones related to social interactions, communication, and behavior. This is a key age range for detecting early signs of autism spectrum disorder (ASD) when symptoms may start to manifest. Early identification and intervention for ASD can lead to improved outcomes and quality of life for children. Options A, C, and D are incorrect because they fall outside the recommended screening age range. Screening too early (option A) may not capture subtle signs of ASD that become more apparent as the child grows older. On the other hand, delaying screening until 24 to 36 months (option C) or 36 to 48 months (option D) can result in missed opportunities for early intervention, which is crucial for children with ASD. Educationally, understanding the timing of autism screening in children is essential for healthcare providers, pediatricians, early childhood educators, and parents. By knowing when to conduct these screenings, professionals can work together to ensure timely detection, referral, and support for children who may be at risk for ASD. This knowledge empowers stakeholders to promote early intervention strategies that can positively impact a child's developmental trajectory.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) administer activated charcoal immediately and measure the plasma level of acetaminophen 4 hours after ingestion. The rationale behind this is that activated charcoal helps prevent the absorption of the acetaminophen in the gastrointestinal tract, reducing the overall toxicity. By administering activated charcoal promptly, you can decrease the amount of acetaminophen that enters the bloodstream, thereby minimizing potential harm to the patient's liver. Option A is incorrect because measuring the plasma level at this moment may not accurately reflect the extent of toxicity since the absorption of acetaminophen is ongoing. Waiting until 4 hours after ingestion, as mentioned in option B, delays potential life-saving interventions. Option D is dangerous as ingestion of this magnitude can indeed be toxic and requires immediate medical attention. Educationally, understanding the timing and importance of interventions in cases of acetaminophen overdose is crucial for healthcare providers working with pediatric patients to ensure timely and appropriate care delivery. By grasping the significance of prompt administration of activated charcoal and the timing of plasma level measurements, healthcare professionals can effectively manage acetaminophen toxicity in pediatric patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) behavioral insomnia of childhood. Behavioral insomnia of childhood is characterized by a child's refusal to go to bed, remaining active, and experiencing difficulty falling asleep. This behavior is often due to learned associations, parental responses, or environmental factors that disrupt the child's sleep routine. Option A) thyrotoxicosis is unlikely in this case as it is a medical condition involving an overactive thyroid gland, leading to symptoms such as hyperactivity, but it is not the primary cause of bedtime refusal. Option B) ADHD, while it can present with hyperactivity and difficulties with impulse control, is not the most likely cause in this context unless there are other consistent behavioral patterns and symptoms present. Option D) sleep-onset association disorder involves difficulty falling asleep without certain conditions or associations present, which is not the primary issue in this case. Educationally, understanding common childhood sleep disorders is essential for healthcare providers, parents, and educators to support children's healthy sleep habits. Recognizing the signs, symptoms, and appropriate management strategies for behavioral insomnia of childhood can help address sleep disturbances in children and promote overall well-being and development. It is crucial to consider behavioral and environmental factors when evaluating sleep issues in children to provide targeted interventions and support.