Early sign of shock is:

Correct Answer: D

Rationale: In pediatric nursing, identifying early signs of shock is crucial for timely intervention. The correct answer is D) Tachycardia. Tachycardia, an abnormally fast heart rate, is a key early sign of shock in children. When the body is in shock, the heart beats faster to compensate for decreased blood flow and maintain organ perfusion. This physiological response helps to maintain blood pressure in the early stages of shock. Option A) Hypotension is a late sign of shock in pediatric patients. Children can maintain their blood pressure until shock is advanced, making hypotension a less reliable early indicator. Option B) Disturbed consciousness level is a nonspecific sign that can be seen in various conditions, not specific to shock in pediatric patients. Option C) Cheyne-Stokes breathing is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by periods of apnea. While this may be seen in some cases of shock, it is not as consistently present or reliable as tachycardia in early identification. Educational Context: Understanding the early signs of shock in pediatric patients is vital for nurses to initiate prompt treatment and prevent progression to severe shock. Regular training and practice on recognizing these signs through scenarios and case studies can enhance nurses' clinical judgment and decision-making skills in pediatric emergencies. Encouraging a systematic approach to assessing pediatric patients for signs of shock can improve patient outcomes and safety.

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.

Correct Answer: B

Rationale: The correct answer is B) 4 months. Educational Rationale: At 2 months of age, infants are just beginning to develop their visual abilities and hand-eye coordination. It is around the age of 4 months when infants start to grasp objects intentionally and show interest in exploring items through touch and sound. By giving a 2-month-old a rattle, they may not yet have the motor skills or cognitive development to fully engage with the toy. Providing the rattle at 4 months allows the infant to start practicing their grasping skills, enhancing their sensory exploration, and promoting cognitive development through cause-and-effect relationships. It also encourages the development of fine motor skills and hand coordination, which are important for later developmental milestones like self-feeding and writing. Option A) 2 months is incorrect because infants at this age are still developing their basic reflexes and are not yet ready for intentional play activities with objects like rattles. Options C) 7 months and D) 9 months are also incorrect as by this age, infants have already developed the ability to grasp objects and explore their environment actively. Waiting until 7 or 9 months to introduce a rattle may delay the child's opportunities for sensory and motor skill development during the critical earlier months. In pediatric nursing, understanding developmental milestones and appropriate play activities is crucial for guiding parents on how to support their child's growth and learning. By providing accurate information on when to introduce toys like rattles, nurses can empower parents to engage effectively with their infants, promoting healthy development and bonding.