An adolescent with new-onset diabetes is struggling with 'daytime accidents.' What is this condition called?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Diurnal enuresis. Diurnal enuresis refers to the involuntary loss of urine during the day, which is the specific issue the adolescent with new-onset diabetes is experiencing. Option A) Primary enuresis is bedwetting in a child who has never been consistently dry at night, which does not apply to this adolescent with daytime accidents. Option B) Secondary enuresis is the recurrence of bedwetting after a period of dryness, usually for 6 months or more, which is not the case for the adolescent in the question. Option D) Nocturnal enuresis is bedwetting that occurs at night during sleep, which is not the primary concern for the adolescent with daytime accidents. Understanding the different types of enuresis is crucial in pediatric nursing to provide appropriate care and management for children and adolescents experiencing urinary incontinence issues. Recognizing diurnal enuresis in this case highlights the need for further assessment and intervention to support the adolescent in managing their new-onset diabetes and associated bladder control challenges during the day.

Correct Answer: B

Rationale: In discussing failure to thrive (FTT) with medical students, it is crucial to explain why option B is the correct statement to include in the discussion. Option B states that a weight crossing one major percentile line on the growth chart over time is considered abnormal. This is important because FTT is not solely determined by a single weight measurement but rather by a trend of poor weight gain or weight loss over time. Monitoring a child's growth chart and observing significant deviations from their established growth pattern can help identify FTT early and initiate timely interventions. Options A, C, and D are incorrect for various reasons. Option A is incorrect because using a single weight measurement falling below the 25th percentile for age is not sufficient to diagnose FTT. FTT is a complex condition that requires a comprehensive assessment of growth patterns, nutritional intake, and psychosocial factors. Option C is incorrect as defining FTT by a weight of less than 60% of the median weight for height oversimplifies the diagnosis and does not account for individual variations in growth. Option D is incorrect because while some children may naturally fall below the 3rd percentile due to genetic factors, their weight for height ratio would still be within normal limits, unlike children with FTT. In an educational context, understanding the nuances of diagnosing FTT is essential for healthcare professionals working with pediatric populations. Emphasizing the importance of longitudinal growth monitoring, interpreting growth charts accurately, and considering various factors contributing to FTT can help healthcare providers effectively identify and manage this condition in children.

Correct Answer: A

Rationale: When performing a newborn assessment, it is important to measure the vital signs in the sequence of pulse, respirations, and temperature. This sequence is recommended because measuring the pulse first provides immediate information on the baby's cardiovascular status, followed by respirations to assess respiratory function, and ending with temperature which can be influenced by the other vital signs. This comprehensive approach helps ensure all vital signs are assessed accurately and in a logical order.

Correct Answer: C

Rationale: A recent episode of pharyngitis is most important when obtaining the history of a child suspected of having rheumatic fever because rheumatic fever often develops as a complication of inadequately treated streptococcal pharyngitis. It is crucial to determine if there was a recent streptococcal infection to assess the likelihood of rheumatic fever developing. The other symptoms mentioned, such as fever, lack of interest in food, and vomiting, are important as well, but the connection with the recent episode of pharyngitis is more specifically related to the potential development of rheumatic fever in this case.

Correct Answer: A

Rationale: Polycythemia, which is an abnormally elevated level of red blood cells in the blood, is commonly associated with congenital heart disease. In cases where there is a congenital heart defect that causes reduced oxygen levels in the blood, the body compensates by producing more red blood cells to try to improve oxygen delivery. This increased red blood cell production can lead to polycythemia. In turn, polycythemia can increase the risk of thrombosis, which is a known risk factor for cerebrovascular accidents (CVAs) or strokes. Therefore, polycythemia is most likely associated with a CVA resulting from congenital heart disease.