False positive tuberculin test may be present in:

Correct Answer: C

Rationale: In the context of a pediatric NCLEX practice quiz, the correct answer is C) Infection with atypical mycobacteria. A false positive tuberculin test can occur in individuals who have been exposed to non-tuberculosis mycobacteria, such as Mycobacterium avium or Mycobacterium kansasii. These atypical mycobacteria can cross-react with the tuberculin protein, leading to a positive result even though the person does not have active tuberculosis. Option A) Disseminated infection would likely result in a true positive tuberculin test, as the individual's immune system would be reacting to the presence of Mycobacterium tuberculosis throughout the body. Option B) Live viral vaccine, such as the bacille Calmette-Guérin (BCG) vaccine, can cause a false positive tuberculin test due to its similarity to the tuberculin protein. However, the question specifically asks about atypical mycobacteria, not the BCG vaccine. Option D) Active infection with Mycobacterium tuberculosis would also result in a true positive tuberculin test, as the immune response would be triggered by the presence of the actual tuberculosis bacteria. Understanding the reasons behind false positive results in tuberculin testing is crucial for healthcare professionals working with pediatric patients, as it can impact the interpretation of test results and subsequent treatment decisions. By differentiating between various causes of false positives, nurses and other healthcare providers can ensure accurate diagnosis and appropriate management of pediatric patients at risk for tuberculosis.

Correct Answer: C

Rationale: In newborns, severe coarctation of the aorta is associated with heart failure due to the narrowing of the aorta, leading to increased pressure in the left ventricle and decreased blood flow to the body. This results in heart failure symptoms such as poor feeding, tachypnea, and weak pulses. Large VSD and large ASD can cause increased pulmonary blood flow but do not typically present with heart failure in the newborn period. In the case of severe Tetralogy of Fallot, cyanosis is more prominent than heart failure symptoms in the immediate newborn period. Educationally, understanding the pathophysiology of congenital heart diseases is crucial for nurses caring for pediatric patients. Recognizing the signs and symptoms of heart failure in newborns is essential for early intervention and optimal outcomes. This question reinforces the importance of differentiating between various congenital heart diseases and their associated clinical presentations.

Correct Answer: C

Rationale: In the clinical picture of acute congestive heart failure, the presence of a firm, non-tender liver (Option C) is not typically expected. This is because in congestive heart failure, the liver may become enlarged and tender due to congestion and impaired circulation. Option A, edema in the lower limbs, is a common manifestation of heart failure due to fluid retention and increased venous pressure. Option B, congested pulsating neck veins, is seen in heart failure as a result of increased pressure in the superior vena cava. Option D, basal lung crepitations, are also commonly found in heart failure due to fluid accumulation in the lungs. Educationally, understanding the clinical manifestations of acute congestive heart failure is crucial for healthcare professionals caring for pediatric patients. Recognizing these signs and symptoms promptly can lead to early intervention and improved outcomes. The absence of a tender liver in this context highlights the importance of assessing multiple symptoms comprehensively to reach accurate clinical judgments.

Correct Answer: C

Rationale: In infants with a large Ventricular Septal Defect (VSD), it is crucial to understand the typical clinical findings associated with this congenital heart defect. Firstly, the correct answer is option C) Normal growth parameter. This is because infants with a large VSD often exhibit poor weight gain and failure to thrive due to increased metabolic demands from the heart defect. Option A) Grade II pansystolic murmur in the left parasternal area is typically present in infants with a VSD. This murmur is caused by the turbulent blood flow across the defect. Option B) Accentuated second heart sound on the 2nd left intercostal space is also common in infants with a VSD. This occurs due to increased blood flow across the pulmonary valve. Option D) Hyperdynamic precordium is another expected finding in infants with a large VSD. The increased flow of blood through the defect results in a palpable and visible pulsation of the heart. Educationally, understanding the clinical manifestations of congenital heart defects like VSD is vital for nurses and healthcare professionals caring for pediatric patients. Recognizing these findings can lead to early detection, appropriate interventions, and improved outcomes for infants with congenital heart defects.

Correct Answer: A

Rationale: The correct answer is A) Bacterial pneumonia. Pleural effusion in children is most commonly caused by bacterial pneumonia due to the inflammatory response triggered by the infection. Bacterial pneumonia leads to an accumulation of fluid in the pleural space, causing pleural effusion. This is a key concept in pediatric nursing as pneumonia is a common respiratory infection in children that can lead to serious complications like pleural effusion. Option B) Congestive heart failure is less likely to cause pleural effusion in children compared to adults. In children, cardiac causes of pleural effusion are less common. Option C) Viral pneumonia can cause pleural effusion, but it is not as common as bacterial pneumonia in children. Option D) Metastatic intrathoracic malignancy is a rare cause of pleural effusion in children. Malignancies are less common in pediatric populations compared to adults. Understanding the common causes of pleural effusion in children is crucial for nurses working in pediatric settings. Recognizing the signs and symptoms of bacterial pneumonia and its potential complications, such as pleural effusion, is essential for prompt and effective nursing care. By knowing the common etiologies of pleural effusion in children, nurses can provide timely interventions and improve patient outcomes.