Childhood psychosis may include all the following EXCEPT

Correct Answer: D

Rationale: In pediatric nursing, understanding childhood psychosis is crucial for providing effective care. The correct answer, D) acute phobic hallucination, is not typically associated with childhood psychosis. A) Delusions, B) loss of reality testing, and C) disorganized speech are common features seen in childhood psychosis. Delusions involve fixed false beliefs, loss of reality testing refers to an inability to distinguish between what is real and what is not, and disorganized speech is a hallmark symptom of conditions like schizophrenia in children. These symptoms can significantly impact a child's daily functioning and require prompt recognition and appropriate intervention. Educational context: By knowing the distinguishing features of childhood psychosis, pediatric nurses can collaborate effectively with other healthcare professionals to provide comprehensive care to children experiencing these symptoms. Recognizing the absence of acute phobic hallucinations in childhood psychosis helps nurses differentiate it from other conditions and tailor interventions to meet the unique needs of these young patients.

Correct Answer: D

Rationale: The correct answer is D) a poor prognosis. After severe birth asphyxia, infants may develop motor automatisms which are involuntary, stereotypical movements. These automatisms are a sign of severe neurological damage and indicate a poor prognosis for the infant's long-term outcomes. It is essential for pediatric nurses to recognize and understand these signs to provide appropriate care and support to both the infant and their family. Option A) absence of oral-buccal-lingual movements is incorrect because motor automatisms typically involve repetitive movements rather than a complete absence of movements. Option B) time-synchronized electroencephalographic discharges is incorrect as it describes a phenomenon seen in epileptic seizures rather than motor automatisms following birth asphyxia. Option C) significant cortical epileptic activity is incorrect because while birth asphyxia can lead to seizures and abnormal brain activity, the presence of motor automatisms is more indicative of severe neurological damage rather than specific epileptic activity. Understanding the neurological consequences of birth asphyxia is crucial for pediatric nurses as they play a key role in monitoring, assessing, and providing care to these vulnerable infants. By recognizing the significance of motor automatisms as a poor prognostic indicator, nurses can work collaboratively with the healthcare team to optimize outcomes and provide holistic care to these infants and their families.

Correct Answer: D

Rationale: In the case of Respiratory Distress Syndrome (RDS) in newborns, the basic defect requiring treatment is inadequate pulmonary exchange of oxygen and carbon dioxide, which is option D. This is because RDS is primarily a condition characterized by surfactant deficiency in the lungs, leading to poor gas exchange. Treatment strategies for RDS focus on improving oxygenation and ventilation to support the infant's respiratory function. Option A, metabolic acidosis, is not the primary defect in RDS. While metabolic acidosis can occur as a result of respiratory distress, it is a secondary effect rather than the underlying cause of RDS. Option B, circulatory insufficiency, is also not the primary defect in RDS. While RDS can lead to complications that affect the circulatory system, such as hypotension, the main issue in RDS is related to respiratory function rather than circulatory problems. Option C, hypothermia, is not the basic defect requiring treatment in RDS. While maintaining appropriate body temperature is important in managing RDS, hypothermia itself is not the primary issue that needs to be addressed in this condition. In an educational context, understanding the underlying pathophysiology of RDS is crucial for nurses caring for newborns with this condition. By recognizing that the main defect is inadequate pulmonary exchange of oxygen and carbon dioxide, nurses can implement appropriate interventions to support respiratory function and improve outcomes for these vulnerable patients. This knowledge allows nurses to provide effective and evidence-based care for infants with RDS, optimizing their chances for recovery.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding congenital diaphragmatic hernia (CDH) and its associated anomalies is crucial for providing comprehensive care to affected infants. In this case, the correct answer is B) CNS lesions, as CNS anomalies are not commonly associated with CDH. Pulmonary hypoplasia is a key feature of CDH due to lung compression in utero, leading to respiratory distress at birth. Esophageal atresia can be present in CDH cases, as the herniation of abdominal contents can affect the development of the esophagus. Cardiovascular lesions are also commonly seen in CDH patients, as the defect can impact cardiac development and function. Educationally, this question serves to reinforce the understanding of common anomalies associated with CDH and the importance of recognizing atypical findings that may suggest additional complications. By differentiating between the expected and unexpected anomalies in CDH cases, nurses can better advocate for appropriate diagnostic and management strategies to optimize patient outcomes.

Correct Answer: D

Rationale: In pediatric nursing, understanding the therapeutic effects of phototherapy is crucial for managing neonatal jaundice effectively. The correct answer, D) in vivo metabolism and excretion of bilirubin, is not a factor that directly influences the therapeutic effect of phototherapy. Phototherapy works by converting unconjugated bilirubin in the skin to water-soluble isomers that can be excreted easily. Therefore, the metabolism and excretion of bilirubin in the body do not determine the efficacy of phototherapy. A) The distance between the lights and the infant is crucial as it determines the intensity of light exposure, which directly impacts the breakdown of bilirubin. B) Skin color plays a role in how quickly bilirubin can be broken down, as darker skin may require longer exposure to achieve the same effect. C) The surface area of exposed skin is important as a larger surface area allows for more efficient absorption of light and thus better treatment outcomes. In an educational context, nurses need to comprehend the principles behind phototherapy to provide safe and effective care to neonates with jaundice. By understanding the factors that influence the therapeutic effect of phototherapy, nurses can make informed decisions regarding treatment protocols and monitor patients effectively to ensure optimal outcomes.