Erosive esophagitis is found in approximately 12% of children with GERD symptoms and is more common in the following EXCEPT

Correct Answer: A

Rationale: In the context of pediatric gastroesophageal reflux disease (GERD) assessment, understanding the prevalence of erosive esophagitis and its associated factors is crucial for effective diagnosis and management. The correct answer, "A) girls," is more likely to be wrong because erosive esophagitis is actually more common in boys than girls. This gender difference in the prevalence of erosive esophagitis in children is an important clinical consideration when evaluating pediatric patients with GERD symptoms. Option B) older children may be incorrectly perceived as more prone to erosive esophagitis due to prolonged exposure to risk factors; however, the condition can occur across various age groups. Option C) neurologically abnormal children are at higher risk due to impaired esophageal function and increased reflux episodes. Option D) children with severe chronic respiratory disease are also more susceptible due to the association between respiratory issues and GERD. Educationally, understanding the nuances of risk factors associated with erosive esophagitis in pediatric patients with GERD symptoms is essential for healthcare providers. This knowledge informs appropriate diagnostic strategies, treatment plans, and the importance of individualized care based on patient characteristics. By recognizing the specific risk factors and prevalence rates, healthcare professionals can tailor their approach to managing GERD in children effectively.

Correct Answer: B

Rationale: In this case, option B is the correct answer. Phytobezoars are not composed of a combination of plant and animal material, but rather only plant material. Trichobezoars are indeed composed of the patient's own hair, making option A true. Lactobezoars can resolve when feedings are withheld for 24-48 hours, as mentioned in option C. Sunflower seed bezoars have been reported to cause small bowel obstruction, making option D accurate. Educationally, understanding different types of bezoars is crucial for healthcare providers when assessing pediatric gastrointestinal issues. Trichobezoars are commonly seen in individuals with trichotillomania or trichophagia, highlighting the importance of mental health considerations in pediatric care. Lactobezoars are typically found in premature infants and can impact feeding and digestion. Sunflower seed bezoars serve as a reminder of the potential risks associated with certain dietary habits. By knowing these distinctions, healthcare professionals can provide more targeted care and interventions for pediatric patients with gastrointestinal concerns.

Correct Answer: C

Rationale: In pediatric patients with chronic constipation unresponsive to dietary and activity changes, the most appropriate pharmacological measure is option C) Osmotic agent (stool softener). The rationale behind choosing an osmotic agent is that it helps to soften the stool by drawing water into the intestines, making it easier for the child to pass stools. This is particularly beneficial in cases of chronic constipation where stool hardening is a common issue. Osmotic agents are considered safe and effective for pediatric use, especially when other measures have not yielded the desired results. Option A) Natural supplements and herbs may not provide the necessary efficacy and consistency required for managing chronic constipation in pediatric patients. Stimulant laxatives (Option B) can be harsh on the intestines and are generally not recommended for long-term use in children. Option D) stating that pharmacological measures are not used in pediatric constipation is incorrect as there are safe and effective pharmacological options available for managing chronic constipation in children under medical supervision. Educationally, it is important to understand the pharmacological options available for managing pediatric gastrointestinal issues like chronic constipation. Knowing the appropriate use of osmotic agents in such cases can help healthcare providers make informed decisions to optimize patient care and outcomes. It is essential to consider factors like safety, efficacy, and age-appropriate dosing when selecting pharmacological interventions for pediatric patients with gastrointestinal disorders.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Prepare to administer antibiotics intravenously. Necrotizing enterocolitis (NEC) is a serious condition that involves inflammation and damage to the intestinal tissue, often seen in premature infants or those with perinatal stress like an anoxic episode. Antibiotics are a crucial part of the treatment for NEC to address the bacterial overgrowth and prevent further complications. Option A is incorrect because removing the feeding nasogastric tube (NGT) without addressing the underlying issue of NEC would not be beneficial. Option B, obtaining vital signs every 4 hours, is important but not the priority in a suspected case of NEC where prompt treatment is crucial. Option D, changing feedings to half-strength and administering slowly, is not the immediate intervention needed for NEC. From an educational standpoint, understanding the importance of early recognition and intervention in NEC is vital for pediatric nurses. Recognizing the signs and symptoms of NEC, such as abdominal distention, bloody stools, and feeding intolerance, and knowing the appropriate actions to take, including initiating antibiotic therapy, can significantly impact patient outcomes in infants at risk for this condition.

Correct Answer: B

Rationale: In this scenario, the most appropriate action is option B: Encourage the child to blow bubbles. This is the correct choice because the child is showing signs of atelectasis, which is a common complication post-appendectomy due to shallow breathing. Blowing bubbles can help improve lung expansion and prevent atelectasis by encouraging deep breathing and coughing. Option A is incorrect because teaching the child how to use an incentive spirometer may be too advanced for a 3-year-old and may not be as effective in promoting deep breathing as blowing bubbles. Option C is incorrect because obtaining an order for intravenous antibiotics is not indicated based solely on the child's symptoms of fever and diminished breath sounds. Antibiotics should be prescribed based on a confirmed diagnosis of infection. Option D is incorrect as administering Tylenol may help with fever management, but it does not address the underlying issue of atelectasis. In an educational context, it is crucial for nurses caring for pediatric patients to understand the importance of respiratory assessment and interventions to prevent complications like atelectasis. Teaching appropriate techniques like blowing bubbles can be a fun and effective way to promote respiratory function in young children post-surgery.