Generalized anxiety disorder (GAD) is characterized by 6 or more months of persistent, out of proportion worry and anxiety. Of the following, children have less prominent anxiety symptoms in

Correct Answer: D

Rationale: In this question, the correct answer is D) celebration activity. Children with generalized anxiety disorder (GAD) typically have less prominent anxiety symptoms in celebratory activities because these events are usually associated with positive emotions and excitement, which can temporarily alleviate anxiety. Option A) school performance is incorrect because school-related activities can often trigger anxiety in children with GAD due to the pressure to perform academically. Option B) competitive sports is incorrect as these activities can exacerbate anxiety in children with GAD due to the competitive nature and performance expectations. Option C) non-competitive sports is also incorrect as even though the pressure may be lower compared to competitive sports, any form of performance can still trigger anxiety in children with GAD. Educationally, understanding how anxiety manifests in different scenarios is crucial for pediatric nurses as they care for children with GAD. Recognizing that celebratory activities may provide temporary relief can help nurses support these children in managing their anxiety effectively.

Correct Answer: D

Rationale: In this question on pediatric nursing certification practice, the correct answer is D) inappropriate ADH. Neuroleptic antipsychotic agents commonly cause a range of side effects, including bradykinesia, hyperthermia, and tardive dyskinesia. Inappropriate ADH secretion, however, is not typically associated with neuroleptic medications. Bradykinesia refers to slow movement, a common side effect of neuroleptic drugs due to their impact on dopamine receptors. Hyperthermia can occur as a result of neuroleptic malignant syndrome, a serious adverse reaction to antipsychotic medications. Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements of the face and body, often seen with long-term neuroleptic use. In a pediatric nursing context, understanding the side effects of medications is crucial for safe and effective patient care. Recognizing the potential adverse effects of neuroleptic antipsychotic agents allows nurses to monitor for and manage these side effects promptly. This knowledge ensures the well-being of pediatric patients receiving these medications and contributes to overall quality of care.

Correct Answer: D

Rationale: Munchausen by proxy syndrome is a form of child abuse where a caregiver, typically a parent, fabricates or induces illness in a child to gain attention or sympathy. The correct answer, D) an attentive parent caregiver who never goes home, is the exception among the options because in cases of Munchausen by proxy, the caregiver is usually overly attentive and present at all times to maintain control over the child's care and to continue the abuse. Option A, recurrent illness that cannot be explained, is characteristic of Munchausen by proxy as the caregiver often fabricates symptoms leading to repeated medical visits and tests. Option B, experienced pediatricians stating that they have never seen such a case, is incorrect as Munchausen by proxy cases can be challenging to diagnose but are not unheard of in pediatric practice. Option C, symptoms that disappear with the parent present, is also common in Munchausen by proxy cases as the caregiver may induce symptoms that mysteriously resolve when they are not around. In an educational context, understanding Munchausen by proxy syndrome is crucial for healthcare professionals working with children and families. Recognizing the signs and symptoms of this form of abuse is essential to protect the child from harm and to provide appropriate support and intervention for both the child and the caregiver. Educating healthcare providers about this syndrome can help in early identification and prevention of further harm to the child.

Correct Answer: B

Rationale: The most appropriate next step in this scenario is option B, polysomnography. Polysomnography is a diagnostic test used to evaluate sleep patterns and diagnose sleep disorders, such as obstructive sleep apnea (OSA), which could be the underlying cause of the child's symptoms like snoring, daytime sleepiness, and behavioral issues. In this case, the child's symptoms, along with the presence of enlarged tonsils, are suggestive of OSA, making polysomnography the best choice for further evaluation. Option A, laryngoscopy, is not the most appropriate next step because it focuses on examining the larynx and may not provide comprehensive information about the child's sleep patterns and potential sleep disorder like OSA. Option C, ambulatory apnea monitor, is also not the most appropriate next step as it is used for monitoring breathing patterns at home and may not provide as detailed information as polysomnography in diagnosing sleep disorders. Option D, telemetry, is not relevant in this context as it is a method used for monitoring physiological parameters remotely and is not indicated for the evaluation of sleep disorders in pediatric patients. In an educational context, understanding the importance of appropriate diagnostic tests in pediatric patients with symptoms suggestive of sleep disorders is crucial for nurses working in pediatric settings. Recognizing the signs and symptoms of conditions like OSA in children and knowing the appropriate diagnostic steps can lead to timely interventions and improved outcomes for pediatric patients.

Correct Answer: C

Rationale: In this question, the correct answer is C) 75%. This percentage represents the most acceptable risk of dying from leukemia before the age of 10 due to in utero radiation exposure. The rationale behind this is that research and statistical data have shown that exposure to radiation in utero significantly increases the risk of developing leukemia in children. The percentage of 75% signifies a higher likelihood of this adverse outcome compared to the other options provided. Option A) 32%, Option B) 52%, and Option D) 92% are incorrect as they do not accurately reflect the increased risk associated with in utero radiation exposure leading to leukemia mortality before the age of 10. These percentages are lower or higher than the most acceptable risk percentage of 75%, making them less plausible in this context. From an educational perspective, understanding the correlation between radiation exposure in utero and the subsequent risk of leukemia mortality is crucial for pediatric nurses. This knowledge can guide healthcare professionals in advocating for necessary precautions to minimize radiation exposure during pregnancy and ensure the safety and well-being of both the mother and the developing fetus. By choosing the correct answer, nurses demonstrate their comprehension of the potential risks and can implement preventive measures effectively in clinical practice.