Approximately 90% of youths who complete suicide have a preexisting psychiatric illness. Of the following, the MOST commonly encountered illness is

Correct Answer: A

Rationale: The correct answer is A) major depression. In pediatric nursing, understanding the link between psychiatric illnesses and suicide risk is crucial for early identification and intervention. Major depression is the most commonly encountered psychiatric illness in youths who complete suicide. This is because depression can significantly impair one's ability to cope with stressors and can lead to feelings of hopelessness and worthlessness, increasing suicide risk. Option B) schizophrenia spectrum disorders are less commonly associated with suicide in youths compared to major depression. While individuals with schizophrenia have an increased risk of suicide compared to the general population, the prevalence is lower in youths. Option C) conduct disorder is associated with behavioral issues rather than mood disturbances like depression. While conduct disorder is a risk factor for various negative outcomes, including criminal behavior, it is not as strongly linked to suicide as major depression. Option D) chronic anxiety can contribute to distress and impair daily functioning, but it is not typically the primary psychiatric illness seen in youths who complete suicide. Anxiety disorders are more likely to manifest as avoidance behaviors rather than direct self-harm. Educationally, this question highlights the importance of recognizing and addressing psychiatric illnesses in pediatric patients, especially when assessing suicide risk. By understanding the most common psychiatric illnesses associated with suicide, nurses can implement appropriate screening, monitoring, and interventions to support at-risk youths effectively.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) intestinal pseudo-obstruction. Polyhydramnios is an excess of amniotic fluid surrounding the fetus in the womb. This condition can occur when the fetus is unable to swallow amniotic fluid due to gastrointestinal issues such as intestinal pseudo-obstruction. Option A) renal agenesis (Potter syndrome) is associated with oligohydramnios, a decreased amount of amniotic fluid, due to impaired fetal renal function. Option B) Prune-belly syndrome is characterized by abdominal muscle deficiency and urinary tract abnormalities, but it is not typically linked to polyhydramnios. Option C) pulmonary hypoplasia is underdeveloped lungs, which can lead to oligohydramnios due to decreased fetal respiratory movements. In an educational context, understanding the association between polyhydramnios and different fetal conditions is crucial for pediatric nurses. It helps in early identification of potential issues, appropriate prenatal counseling, and planning for the care of neonates with specific health needs. This knowledge allows nurses to provide comprehensive care to both the mother and the newborn, ensuring the best possible outcomes for both.

Correct Answer: A

Rationale: In the context of pediatric nursing, understanding the etiology of seizures in newborns is crucial for effective care and intervention. Seizures beginning in the delivery room or shortly after birth may be indicative of hypoxic-ischemic encephalopathy (HIE), making option A the correct answer. HIE occurs due to inadequate oxygen and blood supply to the brain, often resulting from perinatal asphyxia during labor or delivery. This lack of oxygen can lead to brain injury and subsequent seizures in newborns. It is essential for pediatric nurses to recognize the signs of HIE early to initiate prompt treatment and prevent further neurological damage. Options B, C, and D can be ruled out in this scenario: - Unintentional injection of maternal local anesthetic into the fetus (Option B) is a rare occurrence and not a common cause of early-onset seizures. - Intracranial hemorrhage (Option C) typically presents with different clinical signs and symptoms, such as altered level of consciousness or focal neurological deficits, rather than isolated seizures. - Hypoglycemia (Option D) can cause seizures in neonates, but it usually manifests slightly later than immediately after birth unless severe and prolonged. By understanding the specific causes of seizures in newborns, pediatric nurses can provide targeted care, closely monitor for complications, and collaborate with the healthcare team to optimize outcomes for these vulnerable patients.

Correct Answer: B

Rationale: In the context of pediatric nursing, the administration of antenatal corticosteroids to women between 24 and 34 weeks of gestation is a crucial intervention to enhance fetal lung maturation and reduce the incidence and mortality of respiratory distress syndrome (RDS) in preterm infants. The correct answer, B) postnatal growth, is the exception because antenatal corticosteroids do not directly impact the postnatal growth of the infant. Option A, incidence and mortality of RDS, is directly affected by antenatal corticosteroids as they improve lung maturity, reducing the risk of RDS. Option C, overall neonatal mortality, is decreased as antenatal corticosteroids lower the likelihood of complications associated with prematurity. Option D, need for and duration of ventilatory support, is also reduced because the improved lung function resulting from corticosteroid administration decreases the severity of respiratory issues in preterm infants. In an educational context, it is essential for pediatric nurses to understand the rationale behind administering antenatal corticosteroids and their impact on neonatal outcomes. This knowledge enables nurses to provide evidence-based care, advocate for optimal treatment strategies, and effectively educate parents on the benefits of this intervention in improving neonatal health outcomes.

Correct Answer: A

Rationale: In pediatric nursing, understanding predisposing factors for conditions like persistent pulmonary hypertension of the newborn (PPHN) is crucial for providing quality care. In this case, the correct answer is A) anemia. Anemia is not typically associated with an increased risk of PPHN. Meconium aspiration syndrome (B), early-onset sepsis (C), and birth asphyxia (D) are all recognized risk factors for PPHN. Meconium aspiration can lead to airway obstruction and inflammation in the lungs, increasing the risk of PPHN. Early-onset sepsis can cause systemic inflammation and compromise respiratory function, contributing to PPHN. Birth asphyxia, which involves a lack of oxygen during birth, can lead to pulmonary vasoconstriction and PPHN. Educationally, this question highlights the importance of recognizing predisposing factors for PPHN to promptly identify and manage at-risk newborns. Understanding these risk factors can guide nursing interventions and support early detection and treatment of PPHN, ultimately improving patient outcomes. Nurses must be well-versed in neonatal conditions and their associated risk factors to provide safe and effective care to newborns.