Cristina, a mother of a 4-year-old child tells the nurse that her child is a very poor eater. What’s the nurse’s best recommendation for helping the mother increase her child’s nutritional intake?

Correct Answer: A

Rationale: The correct answer is A) Allow the child to feed herself. This recommendation aligns with the developmental stage of a 4-year-old child. At this age, children are often exploring their independence and autonomy, including feeding themselves. Allowing the child to feed herself promotes self-regulation and independence, which can positively impact her eating habits. Option B) Using specially designed dishes for children may be appealing but does not directly address the issue of poor eating habits. It focuses more on presentation rather than the child's actual eating behavior. Option C) Only serving the child's favorite foods may limit the child's exposure to a variety of nutrients essential for growth and development. It may reinforce picky eating habits and hinder the child's willingness to try new foods. Option D) Allowing the child to eat at a small table and chair by herself may also promote independence but does not specifically target the issue of poor eating habits. It is important to focus on strategies that directly address the nutritional intake of the child. In an educational context, understanding the developmental stages of children is crucial when providing recommendations related to nutrition. Encouraging independence in feeding can foster positive eating behaviors and help establish healthy eating habits early in life. It is essential for nurses to consider age-appropriate strategies to support children and their families in promoting optimal nutrition and growth.

Correct Answer: A

Rationale: The correct answer is A) Prevent metabolic breakdown of xanthine to uric acid. In pediatric oncology, especially during leukemia treatment, tumor lysis syndrome (TLS) is a potential complication due to the rapid breakdown of cancer cells leading to the release of intracellular contents like purines. Allopurinol is administered to inhibit xanthine oxidase, preventing the conversion of xanthine to uric acid, thus reducing the risk of uric acid crystal formation and subsequent renal damage. Option B is incorrect because allopurinol is not directly involved in preventing uric acid from precipitating in the ureters but rather in inhibiting its formation. Option C is incorrect as allopurinol does not enhance uric acid production but rather inhibits its formation. Option D is incorrect as allopurinol's primary role in this scenario is related to preventing the metabolic breakdown of purines, not protecting the bone marrow from chemotherapy. Understanding the rationale behind using allopurinol in the context of TLS risk during leukemia treatment is crucial for pediatric nurses to provide safe and effective care to their patients undergoing chemotherapy.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Call the poison control center. When a child ingests poison, the immediate priority is to seek expert medical advice. The poison control center is staffed with professionals who can provide specific instructions tailored to the type of poison ingested, the amount, and the age/weight of the child. They can offer guidance on appropriate first aid measures, whether it is necessary to go to the emergency room, and what symptoms to watch out for. Option A) Administer ipecac syrup is no longer recommended in cases of poisoning as it can be harmful and may delay more effective treatments. Option B) Call an ambulance immediately may be necessary in severe cases, but calling the poison control center first can provide valuable guidance on the best course of action. Option D) Punishing the child is not only irrelevant but also counterproductive as it can delay seeking help and create unnecessary stress and fear for the child. In an educational context, it is crucial for parents and caregivers to be aware of the appropriate steps to take in case of poisoning. Teaching them to contact the poison control center first equips them with the necessary knowledge and resources to handle such emergencies effectively. This empowers parents to act quickly and confidently, potentially saving the child's life.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Apply cool air under the cast with a blow-dryer. Itching under a cast is a common complaint, and applying cool air can help relieve the sensation without compromising the cast or skin integrity. Using a blow-dryer on the cool setting can help alleviate itching without introducing moisture, which could lead to skin breakdown or infection. Option B) Using sterile applicators to scratch the itch is incorrect as it can damage the skin under the cast, leading to potential complications such as infection or injury. Option C) Applying cool water under the cast is not recommended as it can introduce moisture, potentially leading to skin maceration and breakdown, increasing the risk of infection. Option D) Applying hydrocortisone cream under the cast using a sterile applicator is not advised as it can also introduce moisture and may not effectively relieve the itching sensation in this scenario. Educational Context: It is essential for nurses working in pediatric cardiovascular nursing to be knowledgeable about proper cast care, especially when dealing with itching, a common issue among pediatric patients. Understanding the appropriate interventions to relieve itching while maintaining the integrity of the cast and the patient's skin is crucial for promoting optimal healing and preventing complications. Nurses play a vital role in educating patients and families on safe and effective methods to address common concerns like itching under a cast, ensuring positive outcomes for their patients.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Blood is circulated through the lungs again, causing pulmonary circulatory congestion. When an infant has a patent ductus arteriosus (PDA), a congenital heart defect where the ductus arteriosus fails to close after birth, it leads to a shunt of blood from the aorta to the pulmonary artery. This causes increased blood flow to the lungs, leading to pulmonary circulatory congestion and eventually resulting in dyspnea (difficulty breathing) as the lungs become overloaded with blood. Option B) Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia, is incorrect because in PDA, blood is actually shunted towards the pulmonary circulation, leading to increased blood flow to the lungs rather than bypassing them. Option C) Blood is shunted past cardiac arteries, causing myocardial hypoxia, is incorrect because PDA primarily affects pulmonary circulation, not cardiac arteries, leading to pulmonary congestion rather than myocardial hypoxia. Option D) Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart, is incorrect because PDA causes blood to flow from the aorta to the pulmonary artery, bypassing the lungs and overloading them with blood, rather than bypassing the left side of the heart. Understanding the pathophysiology of congenital heart defects like PDA is crucial for pediatric cardiovascular nursing. Nurses need to recognize the signs and symptoms of PDA, including dyspnea, to provide appropriate care and interventions to improve the infant's respiratory status and overall condition.