Common observations with vitamin B12 deficiency in children include all the following EXCEPT

Correct Answer: A

Rationale: In pediatric patients with vitamin B12 deficiency, common observations may include a variety of symptoms due to the essential role of vitamin B12 in neurological function and red blood cell production. The correct answer, option A) hyperpigmentation, is the exception because it is not typically associated with vitamin B12 deficiency in children. Option B) involuntary movements, can be seen in children with vitamin B12 deficiency due to its impact on the nervous system. Option C) developmental regression is another possible symptom as vitamin B12 deficiency can affect cognitive function. Option D) peripheral neuritis is also commonly observed in children with vitamin B12 deficiency as it affects the peripheral nerves. Educationally, understanding the symptoms of vitamin B12 deficiency in children is crucial for healthcare providers to recognize and intervene early. By knowing the typical and atypical signs, appropriate diagnostic testing and treatment can be initiated promptly to prevent further complications. This question reinforces the importance of recognizing the diverse presentations of vitamin deficiencies in pediatric patients.

Correct Answer: C

Rationale: In this question, the correct answer is C) hypophosphatasia. Hypophosphatasia is a rare genetic disorder characterized by low levels of alkaline phosphatase, leading to impaired bone mineralization. Parathyroid hormone levels are reduced in hypophosphatasia due to the disruption in bone metabolism caused by the deficiency of alkaline phosphatase. Option A) vitamin D dependent rickets is incorrect because in this condition, there is a defect in the metabolism of vitamin D, leading to impaired calcium absorption in the gut and resulting in elevated parathyroid hormone levels. Option B) X-linked hypophosphatemic rickets is incorrect because it is characterized by low levels of phosphate in the blood, leading to elevated levels of fibroblast growth factor 23 (FGF23) and compensatory increased levels of parathyroid hormone. Option D) dietary calcium deficiency is incorrect because in this scenario, the parathyroid hormone levels would be elevated due to the body's attempt to maintain calcium levels by increasing bone resorption. Educationally, understanding the relationship between different pediatric conditions and their impact on hormone levels is crucial for nurses preparing for the NCLEX exam. This knowledge helps in making clinical decisions and providing appropriate care to pediatric patients with gastrointestinal disorders.

Correct Answer: A

Rationale: Rationale: The correct answer is A) 25-hydroxy vitamin D level. When assessing a patient's vitamin D status, the 25-hydroxy vitamin D level is the standard method used. This is because 25-hydroxy vitamin D is the major circulating form of vitamin D in the body and reflects the overall vitamin D status, making it a reliable indicator of a patient's vitamin D levels. Option B) 1,25-dihydroxy vitamin D level is the active form of vitamin D, but its levels are more tightly regulated by the body and are not as reflective of overall vitamin D status as 25-hydroxy vitamin D. Option C) D-binding protein is involved in the transport of vitamin D in the blood but does not directly indicate vitamin D status. Option D) PTH (parathyroid hormone) level is not a direct measure of vitamin D status, although it is involved in the regulation of calcium and phosphate metabolism in relation to vitamin D. Educational Context: Understanding how to assess and interpret vitamin D status is crucial in pediatric healthcare. By knowing that 25-hydroxy vitamin D levels are the standard method for determining vitamin D status, healthcare providers can effectively evaluate and monitor a child's nutritional status and make appropriate recommendations for supplementation if necessary. This knowledge is vital in promoting optimal bone health and overall well-being in pediatric patients.

Correct Answer: D

Rationale: In this question, the correct answer is D) manganese and decreased alertness. Manganese is a trace element that, when present in excess, can lead to symptoms like decreased alertness, emotional disturbances, and even Parkinson-like symptoms. This is because manganese is involved in various physiological processes in the brain, and an excess can disrupt these functions. Option A) zinc and hypogonadism is incorrect because zinc deficiency, not excess, is associated with hypogonadism. Zinc is crucial for reproductive health, and low levels can lead to hormonal imbalances. Option B) selenium and dental caries is incorrect because selenium excess is not typically associated with dental caries. In fact, selenium deficiency is more commonly linked to problems like weakened immune function. Option C) fluoride and nail changes is incorrect because while excess fluoride can lead to dental fluorosis (affecting teeth), it is not typically known to cause nail changes. For educational context, understanding the effects of trace element excess is crucial in pediatric care. Nurses and healthcare providers need to be aware of the potential consequences of excessive intake of certain trace elements to provide appropriate care and education to patients and their families. Monitoring trace element levels and educating on balanced nutrition are essential aspects of pediatric healthcare.

Correct Answer: D

Rationale: In the context of pediatric gastrointestinal health, it is crucial for nurses preparing for the NCLEX to understand the potential causes of constipation in children. The correct answer "D) ibuprofen" is not typically associated with causing constipation in children. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and reducing inflammation, but it is not a known cause of constipation. Option A, "hypothyroidism," can lead to constipation as it affects metabolism and slows down bowel movements. Hypokalemia, option B, can also cause constipation as low potassium levels can disrupt normal muscle function, including in the intestines. Option C, "lead," can cause constipation as lead poisoning can affect the nerves that control the bowel movements. Educationally, this question highlights the importance of recognizing the various factors that can contribute to constipation in pediatric patients. By understanding these different causes, nurses can effectively assess, intervene, and educate both patients and caregivers on appropriate management strategies to promote gastrointestinal health in children. This knowledge is essential for providing safe and competent care to pediatric patients with gastrointestinal concerns.