Gino Ang, who weighed 7 lbs. at birth, was discharged from the hospital on his 3rd day of life. During the nest 2 weeks at home he developed severe vomiting & weight loss, although his appetite remained good. Finally, Gino's mother brought him to the hospital ER for treatment. Gino's PE revealed severe dehydration, epigastric pain & distention, and a palpable olive-size mass in the right upper quadrant. Careful history taking may reveal that Gino had developed which gastrointestinal symptom besides vomiting?

Correct Answer: B

Rationale: The correct answer is B) Noisy eructations. Gino's presentation with severe vomiting, weight loss, epigastric pain, distention, and a palpable olive-size mass in the right upper quadrant is indicative of pyloric stenosis. Noisy eructations, known as "projectile vomiting," are a classic symptom of pyloric stenosis due to the forceful expulsion of gastric contents. This occurs because the hypertrophied pyloric muscle obstructs the passage of food from the stomach to the duodenum, leading to projectile vomiting. Excessive salivation (option A) is not typically associated with pyloric stenosis. Decreased frequency of stools (option C) is not a common symptom of pyloric stenosis and would not explain Gino's presentation. Fresh blood in the stool (option D) is also not a typical finding in pyloric stenosis. In an educational context, understanding the key clinical manifestations of pyloric stenosis is crucial for pediatric nurses preparing for the NCLEX exam. Recognizing the signs and symptoms of pyloric stenosis can aid in prompt diagnosis and intervention, ultimately improving patient outcomes. Studying specific pediatric conditions like pyloric stenosis helps nurses provide safe and effective care to pediatric patients.

Correct Answer: E

Rationale: In this scenario, the correct answer is not provided in the options listed. However, the most appropriate technique to facilitate lipreading with a hearing-impaired child is to ensure good lighting. Adequate lighting is crucial for the child to clearly see the speaker's facial expressions and lip movements. This helps in enhancing the child's ability to understand the spoken words through lipreading. Speaking words in a loud tone (Option A) may distort lip movements, making it harder for the child to understand. Standing at a distance from the child (Option B) can also hinder the child's ability to see the speaker's lip movements clearly. Keeping sentences short (Option C) can be beneficial, but it is not as critical as ensuring good lighting and clear visibility of facial expressions. Using facial expressions while speaking (Option D) is indeed important as it aids in conveying emotions and context, making lipreading more effective. In an educational context, it is important for healthcare providers to be well-versed in communication techniques for individuals with different needs, such as hearing impairment. Understanding the nuances of lipreading and providing appropriate support can significantly improve the quality of care for these individuals. By implementing strategies like ensuring good lighting and using appropriate facial expressions, healthcare professionals can effectively communicate with hearing-impaired children and support their overall well-being.

Correct Answer: A

Rationale: The correct answer is A) Alterations in ability to communicate. Autism spectrum disorder (ASD) is characterized by deficits in social communication and interaction. Individuals with autism often have challenges with verbal and nonverbal communication, such as understanding and using gestures, maintaining conversations, and interpreting social cues. This core deficit sets autism apart from other developmental disorders. Option B) Behavioral changes are exhibited is incorrect because behavioral changes can be a manifestation of autism but are not a core deficit associated with the disorder. Behavior can vary widely among individuals with autism and is often a result of difficulties in communication and social interaction. Option C) Social interactions are affected is partially correct, as social deficits are a core feature of autism. However, the primary deficit is in communication, which encompasses both verbal and nonverbal aspects of social interaction. Option D) Child responds attentively when called by his/her name is incorrect because this behavior does not capture the comprehensive communication challenges faced by individuals with autism. While some children with autism may have specific responses to their names, this is not a defining feature of the disorder. Educationally, understanding the core deficits of autism is crucial for healthcare providers, especially pediatric nurses, as they play a vital role in early identification and intervention for children with developmental disorders. By recognizing the communication challenges associated with autism, nurses can provide appropriate support and facilitate effective communication strategies for these individuals and their families.

Correct Answer: A

Rationale: In caring for a child with cognitive impairment, the primary goal is to promote optimum development (Option A). This goal is essential as it focuses on enhancing the child's overall growth and reaching their full potential despite their cognitive challenges. By providing appropriate stimulation, support, and interventions tailored to the child's specific needs, healthcare providers can help them achieve the highest level of functioning possible. Option B, developing vocational skills, may not be the primary goal at this stage as the immediate focus should be on addressing the child's developmental needs. Vocational skills can be important later in life but promoting optimum development comes first. Encouraging play (Option C) is certainly beneficial for children with cognitive impairment as it supports their cognitive, social, and emotional development. However, it is not the primary goal; rather, it is a means to achieve the broader goal of promoting optimum development. Option D, helping families develop a care plan and ensuring its adherence, is important for overall care coordination. While involving families in care planning is crucial, the primary goal remains promoting the child's optimum development. In an educational context, understanding the primary goal of caring for children with cognitive impairment is fundamental for nurses and healthcare providers. It guides their interventions, treatment plans, and interactions with both the child and their family. By focusing on promoting optimum development, healthcare professionals can make a significant impact on the child's quality of life and future outcomes.

Correct Answer: D

Rationale: The correct answer is D) Helplessness. When a child becomes ill or injured requiring hospitalization, parents often experience a sense of helplessness. This reaction is common as parents may feel overwhelmed by the situation, unable to directly fix or control their child's health issues. This feeling of helplessness can stem from not being able to protect their child from harm or alleviate their suffering immediately. Option A) Indifference is incorrect because it is rare for parents to be indifferent to their child's illness or injury, especially when hospitalization is required. Parents typically show concern and care for their child's well-being. Option B) Anger is incorrect because while some parents may feel anger in response to their child's illness or injury, it is not typically the most common initial reaction. Anger may surface later as a secondary response to the stress and emotional turmoil of the situation. Option C) Depression is incorrect as the initial reaction of parents is usually not depression. While feelings of sadness and despair may arise during the course of treatment, it is not typically the immediate response to a child's hospitalization. Educationally, understanding the common emotional responses of parents to their child's illness or injury is crucial for healthcare providers, especially nurses. By recognizing and acknowledging these emotions, nurses can provide appropriate support, empathy, and guidance to help parents cope effectively during their child's hospitalization. It is essential for nurses to offer emotional support and resources to help parents navigate through their feelings of helplessness, fear, and uncertainty during such challenging times.