Building a tower by a 22-month-old child requires

Correct Answer: D

Rationale: In this scenario, the correct answer is D) fine motor and symbolic thought. Building a tower by a 22-month-old child involves fine motor skills such as grasping, stacking, and manipulating objects. Additionally, it requires symbolic thought, as the child is using the blocks as symbols to represent a structure. Option A) visual-motor coordination is not the most critical aspect when building a tower with blocks. While visual-motor coordination is important for tasks like drawing or threading beads, it is not the primary skill at play in tower building. Option B) using objects and actions in combination is too broad and does not specifically address the fine motor skills and symbolic thought required for tower building. Option C) gross motor skills are related to larger movements of the body, such as walking or jumping. These skills are not as directly involved in the precise movements needed for building a tower with blocks. In an educational context, understanding the developmental milestones and skills required for tasks like building a tower can help educators assess a child's progress and provide appropriate support and guidance. By recognizing that tower building involves fine motor skills and symbolic thought, educators can create activities that specifically target these areas of development in young children.

Correct Answer: D

Rationale: In the context of pediatric Critical Care Registered Nursing (CCRN) practice, understanding the effects of medications like fentanyl is crucial for providing safe and effective care to critically ill children. The correct answer is D) Acidosis. Fentanyl use is not typically associated with causing acidosis in pediatric patients. Fentanyl is a potent opioid analgesic that primarily affects the central nervous system, leading to pain relief without significant effects on acid-base balance. A) Tachycardia is a possible side effect of fentanyl due to its potential to cause respiratory depression, leading to hypoxia and subsequent compensatory tachycardia. B) Hypotension is a common adverse effect of fentanyl use, as opioids can cause vasodilation and decreased systemic vascular resistance, resulting in low blood pressure. C) Nausea and vomiting are frequently reported side effects of opioid medications like fentanyl due to their effects on the chemoreceptor trigger zone in the brain. Educationally, nurses and healthcare providers need to be aware of the potential side effects and adverse reactions associated with fentanyl use in pediatric patients. By understanding the pharmacological properties of fentanyl, including its effects on various physiological systems, nurses can monitor patients closely, anticipate potential complications, and intervene promptly to ensure patient safety and optimal outcomes.

Correct Answer: C

Rationale: The correct answer is C) She will think that because she can see his body, he must still be here. In this scenario, the child is at a developmental stage where they may struggle to understand abstract concepts like death and spirituality. The child's understanding is concrete and literal, so they may associate the presence of the body with the person still being alive. This is a common cognitive process in young children as they develop their understanding of complex ideas. Option A is incorrect because it reflects a more mature understanding of the separation between body and spirit, which is beyond the cognitive abilities of a 3-year-old. Option B is incorrect as it shows a lack of understanding of the concept of heaven. Option D is incorrect as it assumes the child has a grasp of the concept of not needing a body in heaven, which is not developmentally appropriate for a 3-year-old. Educationally, this question highlights the importance of understanding child development when discussing sensitive topics like spirituality and death with young children. It underscores the need for age-appropriate language and explanations to support children's comprehension and emotional well-being during challenging times.

Correct Answer: B

Rationale: The best response to the parents in this scenario is option B: "The tumor is confined to the abdomen with spread to nearby lymph nodes or peritoneum; however, the prognosis remains very good." This response is the most accurate because it correctly indicates that although the tumor has spread to nearby areas, the prognosis is still positive. Option A is incorrect because it states that the prognosis is poor, which is not the case for stage III tumors with spread to nearby lymph nodes or peritoneum. Option C is incorrect as it inaccurately suggests that the tumor has spread to three other organs, which is not indicative of stage III cancer. Option D is incorrect as it indicates that the tumor has spread to other organs, which is more characteristic of later stages of cancer and not stage III specifically. Educationally, it is crucial for healthcare providers to be able to accurately communicate information about cancer staging and prognosis to patients and their families. Understanding the implications of different stages of cancer can help families make informed decisions about treatment options and prepare for the journey ahead. Providing clear and accurate information can also help alleviate anxiety and empower families to be active participants in the child's care.

Correct Answer: D

Rationale: In children with severe traumatic brain injury (TBI), autonomic dysfunction can manifest as various physiological changes. In this case, the correct answer is D) lowered blood pressure. Autonomic dysfunction in severe TBI typically results in increased sympathetic activity, leading to elevated temperature, heart rate, and respiratory rate. Elevated temperature is a common response to stress and injury due to increased metabolic demands. Elevated heart rate is a compensatory mechanism to ensure adequate tissue perfusion in response to the stress of TBI. Elevated respiratory rate helps maintain appropriate oxygenation levels in the body under stress. Lowered blood pressure, on the other hand, is not a typical manifestation of autonomic dysfunction in severe TBI. In fact, hypotension is often a concerning sign as it can indicate poor perfusion to vital organs and tissues, exacerbating the already critical condition of the child. Educationally, understanding the manifestations of autonomic dysfunction in severe TBI is crucial for healthcare providers caring for these pediatric patients. Recognizing these signs promptly can help in initiating appropriate interventions to stabilize the child's condition and prevent further complications.