Childhood vasculitis encompasses a broad spectrum of diseases that share inflammation of blood vessels. The disease that affects predominantly large blood vessels is

Correct Answer: D

Rationale: The correct answer is D) Takayasu arteritis, as it predominantly affects large blood vessels. Takayasu arteritis is a rare autoimmune disease that causes inflammation in the walls of the aorta and its main branches. This results in narrowing or blockage of these arteries, leading to reduced blood flow to various organs. Option A) Henoch-Schonlein purpura primarily involves small blood vessels and is characterized by a rash, joint pain, gastrointestinal symptoms, and kidney inflammation. Option B) Polyarteritis nodosa affects medium-sized arteries, leading to organ damage due to poor blood supply. It typically does not involve large blood vessels as in the case of Takayasu arteritis. Option C) Kawasaki disease mainly affects medium-sized arteries, particularly the coronary arteries in children. It is characterized by fever, rash, swollen lymph nodes, red eyes, lips, and tongue, and can lead to coronary artery aneurysms if not treated promptly. Educationally, understanding the differences in the types of vasculitis based on the size of blood vessels affected is crucial for pediatric nurses. Recognizing the specific characteristics and target organs of each disease aids in accurate diagnosis, appropriate treatment, and prevention of complications. Nurses play a key role in early identification, monitoring, and management of vasculitis in children to promote optimal outcomes and quality of life.

Correct Answer: B

Rationale: In pediatric nursing, failure to thrive is a critical issue that requires close monitoring and intervention. The correct answer, option B (20-30 gm/kg/day), is the minimal accepted catch-up weight gain for a 10-month-old child with failure to thrive. This rate of weight gain is considered appropriate for achieving catch-up growth without overloading the child's system. Option A (10 gm/kg/day) is too low for a child with failure to thrive to adequately catch up in weight gain. This rate may not provide sufficient nutritional support for the child's growth needs. Option C (40-50 gm/kg/day) and option D (60 gm/kg/day) are too high and could potentially lead to overfeeding, which may overwhelm the child's digestive system and cause other complications. Educationally, understanding the appropriate rate of weight gain in children with failure to thrive is crucial for pediatric nurses. It helps them tailor feeding plans to meet the specific needs of each child, promoting optimal growth and development. Monitoring weight gain closely and adjusting feeding strategies accordingly is essential in managing failure to thrive in pediatric patients.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Erythroblastosis fetalis. Erythroblastosis fetalis occurs when there is an incompatibility between the blood types of the mother and the fetus, leading to the mother's antibodies attacking the baby's red blood cells. This condition can cause anemia, jaundice, and hepatosplenomegaly in the newborn. Option B) Hereditary spherocytosis is a genetic disorder that leads to hemolytic anemia due to abnormal red blood cell shape. However, the clinical presentation in the question, including the positive Coombs test and Apgar scores, is more indicative of an immune response causing hemolysis rather than a genetic defect. Option C) Chronic fetal-maternal hemorrhage is unlikely in this case as the infant's symptoms are more suggestive of a hemolytic process rather than hemorrhage. Option D) ABO incompatibility is another condition where the mother's antibodies attack the baby's red blood cells, but it typically presents with less severe symptoms compared to erythroblastosis fetalis. Educationally, understanding these differentials is crucial for pediatric nurses to provide appropriate care for neonates experiencing hemolytic processes. Recognizing the signs and symptoms of erythroblastosis fetalis can lead to prompt interventions such as exchange transfusions to prevent severe complications in affected infants.

Correct Answer: D

Rationale: The correct answer is D) Congenital myasthenia gravis. In this scenario, the patient's presentation of being limp with intact consciousness and lack of crying when toes are pinched is suggestive of a neuromuscular disorder affecting the skeletal muscles. Congenital myasthenia gravis is a rare genetic disorder that impairs the transmission of signals between nerves and muscles, leading to muscle weakness and fatigue. This condition can manifest in infancy with symptoms such as poor feeding, weak cry, and respiratory difficulties, which align with the patient's presentation in the question. Option A) Congenital botulism is incorrect because it typically presents with symptoms such as constipation, weak cry, poor feeding, and respiratory distress, but typically does not involve intact consciousness and awareness as seen in the patient. Option B) Narcotic overdose is unlikely in this case as it would typically result in respiratory depression, altered consciousness, and other signs of central nervous system depression, which are not evident in the scenario described. Option C) Transection of the spinal cord is unlikely given the patient's intact consciousness and awareness of the surroundings, which would not typically be present in such a severe spinal cord injury scenario. Educationally, understanding the differential diagnoses for a limp, non-crying infant after intubation and resuscitation is crucial for pediatric nurses. Recognizing the specific presentation of congenital myasthenia gravis in infants is important for prompt diagnosis and management to prevent complications and improve outcomes for these vulnerable patients. This case highlights the importance of thorough assessment, knowledge of pediatric conditions, and clinical reasoning skills in pediatric nursing practice.

Correct Answer: A

Rationale: In pediatric nursing, understanding hyperbilirubinemia in infants is crucial as it is a common condition that requires prompt assessment and management. In this scenario, the correct answer is A) Physiologic jaundice. Physiologic jaundice is a normal occurrence in newborns due to the immature liver's inability to efficiently process bilirubin. It typically appears after the first 24 hours of life, peaks around 3-5 days, and resolves within a week. It is considered a benign and self-limiting condition that does not require immediate intervention. Option B) Hypothyroidism is incorrect because hypothyroidism can present with jaundice due to decreased conjugation of bilirubin, but it usually occurs later in infancy and is not a common cause of jaundice in the first weeks of life. Option C) Pyloric stenosis is incorrect as it presents with non-bilious vomiting and failure to thrive, rather than jaundice. Option D) Biliary atresia is incorrect because it is a serious condition that presents with persistent jaundice, acholic stools, and hepatomegaly within the first few weeks of life, not at weeks of age as mentioned in the question. Educationally, understanding the differential diagnoses of hyperbilirubinemia in infants is essential for nurses to provide comprehensive care. Recognizing the differences between physiologic jaundice and pathological causes like hypothyroidism, pyloric stenosis, and biliary atresia helps in early identification and appropriate management of these conditions to prevent complications and ensure optimal outcomes for neonates.