Early sign of shock is:

Correct Answer: D

Rationale: In pediatric nursing, recognizing the early signs of shock is crucial for timely intervention. The correct answer is D) Tachycardia. In pediatric patients, tachycardia is often one of the earliest signs of shock. When the body is in a state of shock, the heart rate increases as a compensatory mechanism to maintain adequate tissue perfusion. Therefore, identifying tachycardia early can help healthcare providers intervene promptly to prevent further deterioration. Option A) Hypotension is a late sign of shock in pediatric patients. Children can maintain their blood pressure until shock is quite advanced, making hypotension a less reliable early indicator compared to tachycardia. Option B) Disturbed consciousness level is a significant finding in shock, but it usually occurs in the later stages when the brain is deprived of adequate perfusion. Option C) Cheyne-Stokes breathing is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by periods of apnea. While it can be seen in some cases of shock, it is not as specific or early of a sign as tachycardia in pediatric patients. For educational context, understanding the progression of shock symptoms in pediatric patients is essential for nurses caring for this vulnerable population. By knowing the early signs like tachycardia, nurses can initiate appropriate interventions promptly, potentially preventing further deterioration and improving outcomes for pediatric patients in shock.

Correct Answer: C

Rationale: In hereditary spherocytosis, the correct answer is C) Autosomal recessive. This condition is inherited in an autosomal dominant pattern, which means that one copy of the altered gene in each cell is sufficient to cause the disorder. Therefore, the presence of a single altered gene is enough to manifest the condition. Option A) Splenectomy is the treatment of choice: While splenectomy is a common treatment for hereditary spherocytosis to alleviate symptoms, it is not the only treatment option. Folic acid supplementation and supportive care are also important in managing the condition. Option B) Gallstones are common: Gallstones are indeed common in individuals with hereditary spherocytosis due to the increased breakdown of red blood cells leading to bilirubin accumulation. This can result in the formation of gallstones, which may require intervention. Option D) Can be presented in neonates: Hereditary spherocytosis can indeed present in neonates, with symptoms such as anemia and jaundice becoming apparent early in life. It is crucial for healthcare providers to be aware of this possibility to provide timely diagnosis and management. Educational context: Understanding the genetic inheritance pattern of hereditary spherocytosis is essential for healthcare providers working with pediatric patients. Recognizing the false statement in this question helps reinforce the knowledge of autosomal dominant inheritance in hereditary spherocytosis, while also highlighting key aspects of its presentation and management. This information is vital for nurses specializing in pediatric care to deliver comprehensive and effective patient care.

Correct Answer: B

Rationale: In this question, the correct answer is B) Aplastic anemia. Thrombocytopenia, or low platelet count, with decreased megakaryocytes in the bone marrow is a characteristic finding in aplastic anemia. Aplastic anemia is a condition where the bone marrow fails to produce enough blood cells, including platelets. This leads to a reduction in platelet count and megakaryocytes in the bone marrow. Now, let's analyze why the other options are incorrect: A) ITP (Immune Thrombocytopenic Purpura) is a condition where the immune system destroys platelets, leading to thrombocytopenia. However, it is not associated with decreased megakaryocytes in the bone marrow. C) Hypersplenism is a condition where the spleen prematurely destroys blood cells, including platelets. While it can cause thrombocytopenia, it does not present with decreased megakaryocytes in the bone marrow. D) DIC (Disseminated Intravascular Coagulation) is a condition characterized by widespread activation of coagulation pathways, leading to both bleeding and clotting. While DIC can lead to thrombocytopenia, it does not specifically cause decreased megakaryocytes in the bone marrow. In an educational context, understanding the causes of thrombocytopenia and their associated bone marrow findings is crucial for nurses caring for pediatric patients. Aplastic anemia is a serious condition that requires prompt recognition and intervention to prevent complications. By differentiating between various causes of thrombocytopenia, nurses can provide optimal care and support to 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 around 9 months old, their digestive systems are still developing and maturing. This immaturity can lead to foods like peas and corn not being completely digested, which is a common occurrence at this age. It is important for the nurse to educate the parents that this is a normal part of the infant's digestive process and usually resolves as the infant grows older. Option A is incorrect because withholding fibrous foods until age 4 years is not necessary. Introducing a variety of solid foods is essential for an infant's nutrition and development. Option B is incorrect as it is too extreme. Withholding all solid foods is not required in this situation unless there are other underlying issues that need to be addressed. Option C is incorrect as seeing undigested food in an infant's stool at this age is often due to the immaturity of the digestive system and does not necessarily indicate a serious problem that requires immediate investigation. Educationally, it is crucial for nurses to understand normal infant development, including digestive processes, to provide accurate information and support to parents. By explaining these normal variations, nurses can alleviate parental concerns and promote confidence in caring for their child.

Correct Answer: B

Rationale: In pediatric nursing, understanding child development milestones is crucial for providing appropriate care and guidance to parents. The correct answer is B) 4 months because at this age infants start to develop better hand-eye coordination and are able to grasp objects intentionally. Introducing a rattle at 4 months encourages sensory exploration and helps in developing the infant's fine motor skills. Option A) 2 months is incorrect because infants at this age do not have the necessary motor skills to purposefully grasp and play with a rattle. Option C) 7 months and D) 9 months are also incorrect as by these ages, infants should have already been introduced to and engaged in more complex play activities beyond just a rattle. Educationally, it is important for nurses to educate parents on age-appropriate toys and activities to enhance their child's development. By providing accurate information on when to introduce certain toys based on developmental milestones, nurses empower parents to actively participate in their child's growth and learning journey. This guidance fosters a positive parent-child relationship and promotes the child's overall well-being.