Diagnosis of autistic spectrum disorder (ASD) depends partly but importantly on assessment of language. All the following may raise your concern regarding language development and may indicate ASD EXCEPT

Correct Answer: C

Rationale: In diagnosing autistic spectrum disorder (ASD), language assessment plays a crucial role. Option C, "absent single words by 16 months," is the exception among the given choices that should not raise concern regarding language development and indicate ASD. By 16 months, it is considered within the typical range for a child to not yet have single words, and it is not necessarily indicative of ASD at this age. Options A, B, and D are indicators that may raise concerns about language development and suggest ASD. Absent babbling by 6 months (option A) may indicate a potential issue with early communication skills. Absent gestures by 12 months (option B) is another early red flag for ASD as gestures are a significant part of pre-verbal communication. Absent 2-word purposeful phrases by 24 months (option D) is also a concerning sign, as by this age, children typically begin to combine words to form simple phrases. In an educational context, understanding these developmental milestones and red flags is vital for healthcare professionals working with children, especially pediatric nurses. Recognizing these signs early can lead to timely interventions and support for children with ASD, highlighting the importance of early screening and assessment in pediatric care.

Correct Answer: A

Rationale: In this question regarding true umbilical cord knots, the correct answer is A) short cord. The presence of true umbilical cord knots is indeed associated with various adverse outcomes, including fetal demise. However, a short cord is not typically associated with the formation of true knots. A true umbilical cord knot forms when the fetus moves through a loop in the umbilical cord, causing a knot to develop. This is more likely to occur in situations where there is excess cord length (long cord) rather than a short cord. Small fetal size and polyhydramnios are also not directly linked to the formation of true knots in the umbilical cord. Understanding these associations is crucial for pediatric nurses as they care for newborns and infants who may have had complications during the prenatal period. By recognizing the implications of true umbilical cord knots, nurses can provide appropriate care and support to affected infants and their families.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding cephalohematoma is crucial for providing quality care to infants. In this question, option B is the correct answer because cephalohematoma does not extend across suture lines. Cephalohematoma is a collection of blood between a baby's skull and the periosteum and is limited by suture lines. Option A is incorrect because cephalohematoma is indeed a subperiosteal hemorrhage, which means bleeding underneath the periosteum. Option C is also incorrect as cephalohematoma occurs in approximately 2-3% of live births, not 1-2%. Option D is incorrect because an underlying skull fracture is associated with only a small percentage of cephalohematoma cases, typically around 10-25%. Educationally, knowing these details about cephalohematoma is important for pediatric nurses as they assess and care for infants. Understanding the prevalence, characteristics, and potential complications associated with conditions like cephalohematoma ensures that nurses can provide accurate assessments and interventions for their pediatric patients.

Correct Answer: D

Rationale: In the context of pediatric nursing and neonatal care, the correct answer is D) reduces bronco-pulmonary dysplasia (BPD) rates. Prophylactic and rescue administrations of synthetic and natural surfactants in neonates primarily aim to improve respiratory function and outcomes. While surfactant therapy is effective in reducing adverse outcomes, neonatal mortality, and decreasing the risk for pneumothorax by improving lung compliance and reducing atelectasis, it is not primarily targeted at reducing BPD rates. Reducing BPD rates involves a multifaceted approach that includes strategies beyond surfactant therapy, such as minimizing ventilator-induced lung injury, promoting early extubation, and providing optimal nutrition to promote lung growth and development. In an educational context, understanding the specific goals and limitations of surfactant therapy in neonatal care is crucial for pediatric nurses. It enables them to provide evidence-based care, monitor outcomes effectively, and collaborate with the interprofessional team to optimize the care of critically ill neonates. By grasping the distinct advantages and limitations of surfactant therapy, nurses can contribute to improved patient outcomes and quality of care in neonatal settings.

Correct Answer: C

Rationale: In the context of congenital diaphragmatic hernia (CDH), early respiratory distress within 6 hours of life is a poor prognostic sign because it indicates severe pulmonary hypoplasia. This condition is due to abdominal contents herniating into the chest cavity, leading to lung compression and underdevelopment. The early onset of respiratory distress signifies significant compromise of lung function, making it a critical indicator of poor outcomes in CDH cases. Option A, grunting, and Option B, use of accessory muscles, are signs of respiratory distress commonly seen in various respiratory conditions but are not specific to CDH. These signs can be present in a range of respiratory disorders and do not specifically indicate the severity of CDH in the same way that early respiratory distress does. Option D, a scaphoid abdomen, is a physical examination finding where the abdomen appears sunken or hollow due to the displacement of abdominal contents into the chest cavity. While this is a characteristic finding in CDH, it is not as indicative of poor prognosis as early respiratory distress, which directly reflects the compromised lung function. In an educational context, understanding the significance of early respiratory distress in CDH is crucial for healthcare providers, especially pediatric nurses, as it helps in early identification of high-risk cases that may require immediate interventions such as respiratory support or surgical management. Recognizing these prognostic signs can aid in timely and appropriate patient care, ultimately improving outcomes for infants with CDH.