In a child with failure to thrive, the indications for hospitalization include severe malnutrition or failure of outpatient management. The period after which the child needs hospitalization, if he has not been responded to outpatient management, is about

Correct Answer: B

Rationale: In pediatric nursing, failure to thrive is a serious concern requiring prompt intervention. The correct answer, B) 4 weeks, is the most appropriate indication for hospitalization if outpatient management has failed. This timeline allows for close monitoring and intervention to address the underlying causes of failure to thrive promptly. Option A) 1-2 weeks is too short a period to assess the effectiveness of outpatient management and implement necessary interventions. Hospitalization may be premature within this timeframe and may not allow for an adequate response to treatment. Options C) 2-3 months and D) 4 months are excessively long periods to wait before considering hospitalization. Prolonging hospitalization in these cases could lead to further deterioration in the child's condition and delay essential interventions. Educationally, understanding the appropriate timing for hospitalization in cases of failure to thrive is crucial for pediatric nurses to provide optimal care for these vulnerable patients. By recognizing the signs indicating the need for hospitalization, nurses can intervene early, prevent complications, and improve outcomes for children with failure to thrive.

Correct Answer: D

Rationale: The correct answer is D) Administration of local anesthetic into the fetal scalp. In this scenario, the baby is presenting with signs of perinatal depression, which can be caused by various factors such as birth asphyxia. Administration of local anesthetic into the fetal scalp, while a common practice during instrumental vaginal deliveries, would not directly cause the baby to present with symptoms of perinatal depression. Option A) Prolapsed umbilical cord could lead to fetal hypoxia and subsequent perinatal depression due to compromised blood flow to the baby. Option B) Central nervous system trauma during delivery can also result in perinatal depression. Option C) Administration of morphine to the mother can lead to respiratory depression in the newborn if the drug crosses the placenta. Educationally, understanding the causes of perinatal depression and its management is crucial for pediatric nurses to provide timely and appropriate interventions to stabilize a newborn's condition. It highlights the importance of recognizing potential risk factors during labor and delivery and being prepared to address them promptly to ensure optimal outcomes for both the mother and the newborn.

Correct Answer: D

Rationale: In this question, the correct answer is D) Gilbert disease. Direct-reacting hyperbilirubinemia on the 5th day of life is suggestive of liver pathology. Gilbert disease is characterized by unconjugated hyperbilirubinemia, not direct-reacting hyperbilirubinemia. A) Cystic fibrosis and B) Galactosemia are metabolic disorders that can present with direct hyperbilirubinemia due to liver involvement. C) Neonatal hepatitis is a common cause of direct-reacting hyperbilirubinemia in newborns. Understanding the differential diagnoses of neonatal jaundice is crucial in pediatric nursing. Different etiologies require specific interventions and treatments. Recognizing the characteristics of various conditions aids in prompt diagnosis and appropriate management, ultimately improving patient outcomes. It is essential for nurses to be able to differentiate between different causes of neonatal jaundice to provide optimal care to newborns.

Correct Answer: B

Rationale: In pediatric nursing, understanding common behaviors associated with psychiatric illnesses is essential for providing comprehensive care to children. The correct answer, option B) Sudden overwhelming worries, is not true in many psychiatric illnesses because it specifically refers to symptoms of anxiety disorders rather than a broad range of psychiatric conditions. Option A) Eating very little is a common behavior seen in psychiatric illnesses such as depression or anorexia nervosa. Children may lose their appetite or have disordered eating patterns due to their mental health condition. Option C) Feeling sad or withdrawn is characteristic of mood disorders like depression or adjustment disorders. Children experiencing these conditions may exhibit withdrawal from activities they once enjoyed and have persistent feelings of sadness. Option D) Throwing up can be a symptom of various psychiatric illnesses, including eating disorders like bulimia nervosa or somatic symptom disorders where physical symptoms are manifested due to psychological distress. Educationally, it is vital for nursing students to differentiate between behaviors specific to certain psychiatric illnesses to accurately assess, diagnose, and plan interventions for pediatric patients. Understanding these distinctions helps in providing individualized care tailored to the child's needs and promoting their mental health and well-being.

Correct Answer: D

Rationale: In pediatric nursing, understanding school refusal is crucial as it can impact a child's well-being and academic success. The FALSE statement among the options is D) Somatic symptoms are common. This is incorrect because somatic symptoms are actually common in children with school refusal. These symptoms can manifest as physical complaints like headaches or stomach aches to avoid going to school. Option A is true as school refusal often overlaps with other conditions like anxiety disorders. Younger children commonly experience separation anxiety, making option B correct. Option C is also accurate as older children may have underlying obsessive-compulsive disorders contributing to school refusal. Educationally, knowing these distinctions helps nurses identify and support children experiencing school refusal effectively. By recognizing the false statement, nurses can provide appropriate interventions and collaborate with other healthcare professionals to address the physical and emotional needs of the child, promoting their overall well-being and academic success.