During cardiopulmonary resuscitation of an infant, how should chest compressions be performed?

Correct Answer: D

Rationale: In pediatric nursing, performing chest compressions correctly during infant CPR is crucial for achieving effective resuscitation outcomes. The correct answer, option D - with 2 fingers of one hand, is based on the anatomical considerations of infants. Infants have smaller chests and delicate rib cages compared to adults, requiring a different approach during chest compressions. Using 2 fingers of one hand allows for more precise and controlled pressure over the infant's sternum, ensuring proper compression depth without causing harm. This technique is recommended by the American Heart Association for infants requiring CPR. Option A, with the heel of one hand and the other hand on top of the first, is incorrect as it is the technique used for adult CPR. Applying this method to infants can lead to excessive force and potential injury. Option B, with the heel of one hand only, and option C, with 4 fingers of one hand, are also incorrect as they do not provide the appropriate pressure distribution needed for effective chest compressions on infants. Educationally, it is essential for pediatric nurses to be well-versed in the differences between adult and infant CPR techniques. Understanding the anatomical and physiological distinctions in pediatric patients is crucial for providing safe and effective care during emergencies. Proper training and regular practice in infant CPR techniques are essential for healthcare professionals working with pediatric populations.

Correct Answer: B

Rationale: Tumor lysis syndrome (TLS) is a potential complication seen in pediatric patients with cancer undergoing treatment. When tumor cells break down rapidly, they release large amounts of potassium, phosphorus, and nucleic acids into the bloodstream. This can lead to metabolic abnormalities such as hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia. In the context of TLS, the correct answer is B) Hyperkalemia. This is because as tumor cells lyse, intracellular potassium is released into the bloodstream, leading to elevated serum potassium levels. Hyperkalemia can result in life-threatening cardiac arrhythmias and must be managed promptly. Now, let's discuss why the other options are incorrect: A) Hypernatremia: This is not typically associated with TLS. Hypernatremia refers to high sodium levels in the blood, often caused by dehydration or excessive sodium intake. C) Hypokalemia: Low potassium levels are not a characteristic finding in TLS. Hypokalemia can be caused by factors such as diuretic use or gastrointestinal losses. D) Hyponatremia: Similarly, low sodium levels are not a common feature of TLS. Hyponatremia can occur due to conditions like fluid overload or syndrome of inappropriate antidiuretic hormone secretion (SIADH). In an educational context, understanding the metabolic abnormalities associated with TLS is crucial for pediatric nurses caring for oncology patients. Recognizing the signs and symptoms of TLS, including hyperkalemia, allows for early intervention and prevention of potentially serious complications. Nurses play a vital role in monitoring patients for TLS risk factors and implementing appropriate interventions to ensure patient safety and optimal outcomes.

Correct Answer: C

Rationale: In hereditary spherocytosis, the correct answer is C) Autosomal recessive. This condition is inherited in an autosomal dominant pattern, meaning an individual only needs to inherit one copy of the defective gene from one parent to develop the condition. This is why option C is false. Option A) Splenectomy is the treatment of choice is a common management approach for hereditary spherocytosis to alleviate symptoms and complications associated with the condition. This option is incorrect as it is a valid treatment option. Option B) Gallstones are common is also true in hereditary spherocytosis due to the increased breakdown of red blood cells leading to bilirubin formation, which can contribute to gallstone formation. This option is incorrect as it is a common complication seen in individuals with this condition. Option D) Can be presented in neonates is also correct as hereditary spherocytosis can manifest in the neonatal period or early childhood. This option is incorrect as it accurately represents the presentation of the condition. Educational Context: Understanding the inheritance pattern, clinical manifestations, and management strategies for hereditary spherocytosis is crucial for pediatric nurses caring for patients with this condition. By recognizing the false statement among the options provided, nurses can enhance their knowledge and provide optimal care for pediatric patients with hereditary spherocytosis.

Correct Answer: B

Rationale: In this question, the correct answer is B) Aplastic anemia. Aplastic anemia is a condition characterized by a decrease in all three blood cell types (red blood cells, white blood cells, and platelets) due to bone marrow failure. Thrombocytopenia, which is a low platelet count, can occur in aplastic anemia due to decreased production of megakaryocytes in the bone marrow, leading to a reduction in platelet formation. Option A) ITP (Idiopathic Thrombocytopenic Purpura) is characterized by a decrease in platelet count due to immune destruction of platelets, not decreased production in the bone marrow. Option C) Hypersplenism is a condition where the spleen sequesters and destroys blood cells, leading to a decrease in their circulating levels, but it does not directly affect megakaryocyte production in the bone marrow. Option D) DIC (Disseminated Intravascular Coagulation) is a condition where there is widespread activation of clotting factors leading to both thrombosis and bleeding. While DIC can cause thrombocytopenia, it does not specifically involve decreased megakaryocytes in the bone marrow. Educationally, understanding the different causes of thrombocytopenia is crucial in pediatric nursing practice. Knowing the pathophysiology behind each condition helps nurses in making accurate clinical assessments and providing appropriate interventions. Aplastic anemia is a serious condition that requires prompt recognition and management to prevent complications related to low platelet counts, such as bleeding. This knowledge is essential for nurses caring for pediatric patients with hematologic disorders.

Correct Answer: D

Rationale: The correct answer is D: This is normal because of the immaturity of digestive processes at this age. In infants, especially at 9 months of age, their digestive systems are still developing and maturing. This means that they may not fully digest certain fibrous foods like peas and corn, leading to them being visible in the stool. This phenomenon is considered normal in infants and typically resolves as their digestive system matures with time. Option A is incorrect because it is not necessary to completely avoid fibrous foods until the child is 4 years old. Introducing a variety of foods gradually is important for the child's overall nutrition. Option B is incorrect as avoiding all solid foods is not necessary and could potentially lead to nutritional deficiencies in the infant. Option C is incorrect because in this context, the incomplete digestion of certain foods in an infant's stool is a common occurrence due to the developmental stage of their digestive system. Educationally, understanding the normal developmental processes of infants' digestive systems is crucial for pediatric nurses to provide appropriate guidance to parents and caregivers. By explaining these normal variations, nurses can alleviate concerns and promote healthy feeding practices for infants.