Features suggestive of minor manifestation of acute rheumatic fever include:

Correct Answer: D

Rationale: Arthralgia without objective evidence (swelling, redness) is a minor criterion in acute rheumatic fever. Other minor criteria include fever, elevated acute-phase reactants (ESR, CRP), and prolonged PR interval. The major criteria include carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules.

Correct Answer: C

Rationale: In infants with chronic heart failure, clinical presentations can be subtle yet crucial to recognize. The correct answer, option C, "Acute weight gain due to edema formation," is not typically a typical presentation of chronic heart failure in infancy. In pediatric patients with heart failure, they often present with feeding difficulty (option A) due to poor cardiac output affecting their energy levels and stamina. Excessive sweating with feeding (option B) can occur due to increased work of breathing and effort required during feeding. Nocturnal irritability and cough (option D) may be seen in infants with heart failure due to increased respiratory effort when lying down. Understanding the clinical presentations of chronic heart failure in infants is vital for pediatric nurses as prompt recognition and intervention can significantly impact patient outcomes. By knowing the signs and symptoms, nurses can collaborate with the healthcare team to provide appropriate care and prevent potential complications. It is important to differentiate these symptoms from common infant issues to ensure timely diagnosis and management of heart failure. Regular assessments and monitoring are key components of pediatric nursing care to detect early signs of deterioration and optimize outcomes for pediatric patients with heart failure.

Correct Answer: D

Rationale: In Tetralogy of Fallot, the correct answer is D) Commonly associated with heart failure. This is because Tetralogy of Fallot is a congenital heart defect characterized by four main abnormalities in the heart's structure, including a ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy. These abnormalities can lead to decreased blood flow to the lungs and decreased oxygen levels in the blood, causing cyanosis and clubbing of the fingers. Pulmonary oligemia in chest X-ray (option A) is seen in Tetralogy of Fallot due to reduced blood flow to the lungs. Central cyanosis and clubbing (option B) are common clinical manifestations of Tetralogy of Fallot due to the mixing of oxygen-poor and oxygen-rich blood. Basal ejection systolic murmur and single second heart sound (option C) are also characteristic findings in Tetralogy of Fallot due to the pulmonary stenosis and overriding aorta. Understanding these key clinical features and associations is crucial for nurses caring for pediatric patients with congenital heart defects like Tetralogy of Fallot, as early recognition and appropriate management are essential for optimizing outcomes and preventing complications.

Correct Answer: D

Rationale: In pediatric nursing, understanding the factors influencing the occurrence of atypical bacterial pneumonia is crucial for appropriate patient care. Atypical bacterial pneumonia is more likely to occur in school-aged children (Option D) due to various reasons. School-aged children have increased exposure to different environments, such as school settings where infections can easily spread. They also tend to have more developed immune systems compared to newborn infants (Option A), toddlers (Option B), and preschool children (Option C), making them more susceptible to atypical bacterial pneumonia caused by organisms like Mycoplasma pneumoniae or Chlamydophila pneumoniae. Newborn infants (Option A) are less likely to develop atypical bacterial pneumonia due to the protection provided by maternal antibodies and a relatively sterile environment in the early postnatal period. Toddlers (Option B) and preschool children (Option C) are at a stage where they are still building their immune systems and may be more prone to typical bacterial pneumonia caused by organisms like Streptococcus pneumoniae. Educationally, this question highlights the importance of considering age-related factors when assessing the risk of atypical bacterial pneumonia in pediatric patients. It underscores the need for nurses to be knowledgeable about age-specific vulnerabilities and the pathogens commonly implicated in pediatric respiratory infections. By understanding these nuances, nurses can provide targeted care and interventions to effectively manage and prevent atypical bacterial pneumonia in school-aged children.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Neonatal sepsis. When a term neonate presents with poor feeding, lethargy, and hypothermia, neonatal sepsis should be a significant consideration. Neonatal sepsis is a serious condition characterized by a systemic infection in the newborn, often resulting from bacteria acquired during delivery or from the environment. The symptoms described can be early signs of sepsis in a newborn, making it crucial to promptly evaluate and initiate treatment to prevent further complications. Option B) Transient tachypnea of the newborn is unlikely in this case because the symptoms presented are not consistent with a respiratory issue like transient tachypnea. This condition typically manifests as rapid breathing shortly after birth due to delayed clearance of lung fluid. Option C) Congenital heart disease may present with symptoms like poor feeding and lethargy, but hypothermia is not a common feature. Additionally, the constellation of symptoms is more indicative of a systemic issue like sepsis rather than a cardiac problem. Option D) Hypoglycemia can also present with poor feeding and lethargy, but hypothermia is not a typical symptom. While hypoglycemia should be considered in a differential diagnosis for a neonate with these symptoms, neonatal sepsis is a more urgent concern that requires immediate evaluation and management. Educationally, understanding the differential diagnosis for a neonate presenting with these symptoms is crucial for nurses working in pediatric settings. Recognizing the signs of neonatal sepsis and differentiating it from other common newborn conditions is essential for providing timely and appropriate care to ensure the best outcomes for these vulnerable patients.