Features that would increase suspicion of cerebral palsy at age 9 months include:

Correct Answer: C

Rationale: In pediatric nursing, recognizing red flags for conditions like cerebral palsy is crucial for early intervention and management. In this case, the correct answer is C) Hand dominance. At 9 months, hand dominance is not typically established in infants, and its presence can indicate a compensatory mechanism for motor deficits seen in cerebral palsy. This is a key feature that should raise suspicion for the condition. Option A) Presence of Moro reflex is incorrect because the Moro reflex is a normal primitive reflex seen in infants up to around 6 months of age and its presence at 9 months is not indicative of cerebral palsy. Option B) Abductor spasm is not a typical feature of cerebral palsy in infants at 9 months. Option D) Grasp reflex is a normal developmental reflex in infants and its presence alone does not specifically point towards cerebral palsy. Educationally, understanding the significance of developmental milestones and abnormal findings is essential for pediatric healthcare providers. Recognizing subtle signs like hand dominance can lead to early referrals for further evaluation and intervention, potentially improving outcomes for children with cerebral palsy. This question highlights the importance of keen observation and knowledge of developmental norms in pediatric nursing practice.

Correct Answer: A

Rationale: In the context of pediatric cardiovascular nursing, understanding ABO incompatibility is crucial for providing effective care to newborns. The correct answer, "A) Normal hemoglobin on day 1," is a recognized feature of ABO incompatibility. This is because in ABO hemolytic disease, newborns typically have a normal hemoglobin level at birth due to the delayed onset of hemolysis. Option B, "Worsening with subsequent pregnancies," is incorrect because ABO incompatibility does not worsen with subsequent pregnancies, as seen in Rh incompatibility. Option C, "Conjugated hyperbilirubinemia," is not typically associated with ABO incompatibility. Unconjugated hyperbilirubinemia is more commonly seen in ABO incompatibility. Option D, "Negative Coombs test," is also incorrect because ABO incompatibility is typically diagnosed based on direct antiglobulin test (Coombs test) results, which are positive in this condition. Educationally, understanding these nuances in ABO incompatibility is essential for nurses caring for newborns, as timely recognition and management can prevent severe complications such as kernicterus. By grasping these key features, nurses can provide safe and competent care to infants affected by ABO incompatibility.

Correct Answer: A

Rationale: In pediatric patients with epilepsy, choosing the appropriate anti-epileptic drug is crucial for effective management. Sodium valproate is commonly used in children due to its broad-spectrum activity against various seizure types, making it a suitable option for pediatric epilepsy treatment. - Sodium valproate (Option A) is the correct answer due to its efficacy in managing various types of seizures in children, including absence seizures, myoclonic seizures, and generalized tonic-clonic seizures. It is also well-tolerated and has a lower risk of causing cognitive impairments compared to other anti-epileptic drugs. - Lamotrigine (Option B) is another commonly used anti-epileptic drug, but it is more frequently prescribed in older children and adolescents due to its side effect profile and dosing considerations. It may not be the first choice in younger children. - Topiramate (Option C) is effective in treating seizures in children, but it is often used as an adjunctive therapy rather than a first-line treatment due to its side effects, such as cognitive slowing and weight loss. - Phenytoin (Option D) is less commonly used in children due to its narrow therapeutic index, potential for toxicity, and interactions with other medications. It is often reserved for specific seizure types when other treatments have failed. Educationally, understanding the rationale behind choosing specific anti-epileptic drugs in pediatric patients is essential for nurses caring for children with epilepsy. It involves considering factors such as the child's age, seizure type, comorbidities, potential side effects, dosing considerations, and monitoring requirements to ensure safe and effective treatment. By grasping these concepts, nurses can play a vital role in optimizing the care and outcomes of pediatric patients with epilepsy.

Correct Answer: A

Rationale: In pediatric cardiovascular nursing, understanding common causes of recurrent hematuria is essential for providing effective care. The correct answer is A) Berger's disease. Berger's disease, also known as IgA nephropathy, is a common cause of recurrent hematuria in children. It is characterized by the deposition of IgA immune complexes in the kidneys, leading to inflammation and damage to the glomeruli. Option B) Goodpasture's syndrome is unlikely to cause recurrent hematuria in children. Goodpasture's syndrome is a rare autoimmune disorder that primarily affects the lungs and kidneys, leading to pulmonary hemorrhage and glomerulonephritis. It is more common in adults than in children. Option C) Renal stones typically present with symptoms such as flank pain, hematuria, and urinary tract infections but are not a common cause of recurrent hematuria in children. Option D) Acute post-streptococcal glomerulonephritis can cause hematuria following a streptococcal infection. However, it is usually self-limiting and does not typically result in recurrent episodes of hematuria. Educationally, understanding the differential diagnosis of recurrent hematuria in pediatric patients is crucial for nurses to provide appropriate care, monitor for complications, and collaborate effectively with the healthcare team. By recognizing the distinctive features of each condition, nurses can contribute to accurate assessments, timely interventions, and improved outcomes for pediatric patients with cardiovascular and renal conditions.

Correct Answer: D

Rationale: In the context of pediatric cardiovascular nursing, understanding signs of fetal distress is crucial for timely intervention and ensuring optimal outcomes. Fetal distress, indicating compromised oxygenation and perfusion, is often manifested by bradycardia (option D). Bradycardia signals a significant decrease in fetal heart rate, suggesting potential hypoxia or other serious conditions requiring immediate attention. Option A, meconium staining of liquor, typically indicates fetal bowel movement in utero and is more associated with potential respiratory complications postnatally rather than immediate fetal distress related to cardiovascular issues. Arrhythmias (option B) and tachycardia (option C) may also be concerning but are not specific indicators of fetal distress in the same context as bradycardia. Educationally, this question highlights the importance of recognizing key clinical signs of fetal distress and understanding their implications in the context of pediatric cardiovascular nursing. It underscores the need for nurses to be vigilant in monitoring fetal well-being during labor and delivery, as prompt identification and intervention can significantly impact neonatal outcomes.