Following a traumatic birth of a 10lb infant, the nurse should evaluate

Correct Answer: B

Rationale: A large infant born after a traumatic birth is at risk for shoulder dystocia, which may result in clavicle fracture or damage to the brachial plexus. Evaluating the flexion of both upper extremities can provide important information about any potential injuries. Gestational age status or growth chart percentile will not provide data about traumatic birth injuries, and while large infants are at risk for hypoglycemia, evaluating blood sugar alone may not address potential physical injuries.

Correct Answer: D

Rationale: The correct answer is D) 45%. In a healthy child after birth, the ratio of pulmonary vascular resistance to systemic vascular resistance is approximately 1:1. This means that the pulmonary vascular resistance is equal to systemic vascular resistance. The pulmonary vascular resistance is higher in the fetal circulation to divert blood flow away from the lungs. However, after birth, when the lungs become functional, the pulmonary vascular resistance decreases to match the systemic vascular resistance. Option A) 15% is incorrect because the ratio is not as low as 15% in a healthy child after birth. Option B) 25% is also incorrect as it is not the typical ratio of pulmonary to systemic vascular resistance in this context. Option C) 35% is not accurate as well; the ratio is closer to 1:1 rather than 35%. Understanding the ratios of pulmonary and systemic vascular resistance is crucial in pediatric nursing as it helps in assessing the cardiovascular and respiratory status of a child. This knowledge is essential in managing conditions like congenital heart defects or respiratory distress syndrome in pediatric patients.

Correct Answer: D

Rationale: In pediatric patients with pneumonia, hospital admission is crucial for managing severe cases and preventing complications. The correct answer, option D) vomiting, is not typically an indication for hospital admission in children with pneumonia. Vomiting alone, without other significant symptoms or complications, can often be managed on an outpatient basis. Option A) <6 months age is an indication for hospital admission due to the increased risk of severe illness and complications in infants. Option B) sickle cell anemia is also a risk factor for more severe pneumonia and may necessitate hospitalization for close monitoring and appropriate treatment. Option C) moderate to severe respiratory distress is a critical indication for hospital admission as it signifies significant respiratory compromise and the need for interventions such as supplemental oxygen, respiratory support, and close monitoring of the child's condition. Educationally, understanding the criteria for hospital admission in pediatric pneumonia is vital for nurses and healthcare providers caring for children with respiratory infections. Recognizing the signs and symptoms that warrant hospitalization ensures timely and appropriate management, leading to better outcomes for pediatric patients. It also highlights the importance of individualized care based on a child's specific risk factors and clinical presentation.

Correct Answer: C

Rationale: Cystic fibrosis is a genetic disorder that primarily affects the lungs and digestive system. In this case, the correct answer is C) rectal polyposis. This is because rectal polyposis is not a typical presentation of cystic fibrosis. Option A) salt depletion is a common symptom in cystic fibrosis due to the body losing excessive amounts of salt through sweat. Option B) pansinusitis can occur in cystic fibrosis due to chronic sinus infections. Option D) pancreatitis can also be seen in individuals with cystic fibrosis due to thick mucus blocking the pancreatic ducts. Educationally, understanding the unique manifestations of cystic fibrosis is crucial for nurses caring for pediatric patients with this condition. Recognizing these signs and symptoms can aid in early diagnosis and intervention, ultimately improving patient outcomes. By differentiating between common and uncommon presentations, nurses can provide comprehensive care and support to children with cystic fibrosis.

Correct Answer: D

Rationale: Primary ciliary dyskinesia (PCD) is a genetic disorder that affects the cilia in the respiratory tract, leading to impaired mucociliary clearance. The correct answer, D) Retinitis pigmentosa, is not a clinical manifestation of PCD. Retinitis pigmentosa is a degenerative eye disease that affects the retina and is not associated with PCD. A) Recurrent pneumonia is a common clinical manifestation of PCD due to impaired clearance of respiratory secretions, leading to frequent respiratory infections. B) Chronic otitis media is also commonly seen in PCD due to dysfunctional cilia in the middle ear, leading to recurrent ear infections. C) Chronic pansinusitis is another manifestation of PCD due to impaired clearance of mucus from the sinuses, leading to chronic sinus infections. In an educational context, understanding the clinical manifestations of PCD is crucial for nurses caring for pediatric patients with respiratory conditions. Recognizing these signs and symptoms can help in early identification, appropriate management, and improving patient outcomes. Nurses should be aware of the key features of PCD to provide comprehensive care and support to children and families affected by this condition.