In abetalipoproteinemia, the following is seen in the peripheral blood smear EXCEPT

Correct Answer: D

Rationale: In abetalipoproteinemia, a rare genetic disorder affecting lipid metabolism, the correct answer is D) normal intellectual development. This is because abetalipoproteinemia primarily affects lipid transport, leading to very low plasma levels of cholesterol (option B) and triglycerides (option C). Acanthocytes (spur cells) are also commonly seen in the peripheral blood smear of individuals with abetalipoproteinemia (option A). The incorrect options (A, B, C) are manifestations commonly associated with abetalipoproteinemia due to the inability to properly transport lipids for absorption and metabolism. Acanthocytes result from alterations in lipid composition of the red blood cell membrane. Extremely low levels of cholesterol and triglycerides are characteristic features of this condition as these lipids are typically transported in lipoproteins that are deficient in individuals with abetalipoproteinemia. Educationally, understanding the pathophysiology and clinical manifestations of abetalipoproteinemia is crucial for pediatric gastrointestinal nursing interventions. It helps nurses recognize key signs and symptoms, provide appropriate care, and educate patients and families on dietary modifications and lipid supplementation to manage the condition effectively. The emphasis on intellectual development being normal in abetalipoproteinemia highlights the specific nature of the disorder's impact on lipid metabolism without affecting cognitive function.

Correct Answer: A

Rationale: In the context of pediatric gastrointestinal nursing interventions, understanding the etiology of gastroenteritis outbreaks is crucial for effective management. Direct person-to-person contact outbreaks of gastroenteritis are commonly caused by Shigella. Shigella is highly contagious and can spread rapidly through poor hygiene practices, making person-to-person transmission a significant concern in pediatric settings. Shigella is known for causing severe watery diarrhea, fever, and abdominal cramps, particularly in young children. Its ability to survive in various environments and low infectious dose make it a key culprit in outbreaks involving direct contact. Salmonella, on the other hand, is typically associated with foodborne outbreaks rather than direct person-to-person transmission. Rotavirus is a leading cause of viral gastroenteritis in children but is primarily spread through fecal-oral route rather than direct contact. Clostridium difficile is more commonly linked to healthcare-associated infections rather than direct person-to-person outbreaks. Educationally, emphasizing the modes of transmission of different pathogens causing gastroenteritis helps nurses and healthcare providers implement appropriate infection control measures to prevent and manage outbreaks effectively. Understanding the specific characteristics of each pathogen aids in targeted interventions and reduces the risk of transmission in pediatric populations.

Correct Answer: D

Rationale: In pediatric gastrointestinal nursing, understanding the risks associated with severe dehydration is crucial for providing effective care. The correct answer, option D - depressed level of consciousness, is the most critical indicator necessitating intravenous resuscitation in severe dehydration cases. A depressed level of consciousness signifies severe fluid and electrolyte imbalances, requiring rapid intervention to prevent further complications like shock or organ failure. Option A, age < 9 months, is not the most crucial factor in determining the need for intravenous resuscitation. While infants are more vulnerable to dehydration, the severity of dehydration is better indicated by specific clinical signs like altered consciousness. Option B, postmaturity, is not directly linked to the immediate need for intravenous resuscitation in cases of severe dehydration. Postmaturity may have other implications but is not a primary factor in this scenario. Option C, fever >38°C, while indicating a possible infection or underlying cause of dehydration, is not as urgent an indicator for intravenous resuscitation as a depressed level of consciousness, which directly reflects the severity of dehydration. Educationally, understanding these clinical indicators is vital for nurses caring for pediatric patients with gastrointestinal issues. Recognizing the signs of severe dehydration and knowing when to initiate intravenous resuscitation can be life-saving in pediatric nursing practice. Nurses must be able to prioritize interventions based on the severity of the child's condition to provide optimal care and prevent complications.

Correct Answer: C

Rationale: In pediatric gastrointestinal nursing, the use of ondansetron is common for managing vomiting. The correct answer is C) orally. Ondansetron is typically administered orally in the form of tablets, oral dissolving tablets, or liquid solution in pediatric patients. Administering ondansetron orally is preferred in pediatric patients as it is convenient, non-invasive, and well-tolerated. It allows for easy dosing and administration, especially in children who may have difficulty with intravenous or intramuscular routes. Option A) intravenously and option B) intramuscularly are less preferred in pediatric patients due to the discomfort associated with these routes, especially in children. Intravenous administration may also carry a higher risk of complications such as infection or infiltration. Option D) sublingually is not a common route of administration for ondansetron in pediatric patients. While sublingual administration may offer rapid onset of action, it is not the standard route for this medication in the pediatric population. In an educational context, understanding the appropriate routes of administration for medications in pediatric patients is crucial for nurses to ensure safe and effective care. By knowing the preferred route for ondansetron administration, nurses can optimize treatment outcomes while considering the unique needs and preferences of pediatric patients.

Correct Answer: D

Rationale: In the evaluation of children with suspected appendicitis, the MOST sensitive and specific test is serum amyloid A (SAA) protein. SAA is an acute-phase reactant that increases significantly in response to inflammation, making it a valuable marker for assessing the presence of appendicitis. Elevated levels of SAA have been found to correlate strongly with acute appendicitis, providing a reliable indicator for diagnosis. Leukocyte count (Option A) is a nonspecific marker of inflammation and can be elevated in various conditions, not specific to appendicitis. Urinalysis (Option B) is more relevant in assessing urinary tract issues rather than appendicitis. C-reactive protein (Option C) is an acute-phase reactant like SAA, but SAA has shown to be more specific in the context of appendicitis evaluation. Educationally, understanding the significance of specific biomarkers in diagnosing pediatric gastrointestinal conditions like appendicitis is crucial for nurses working in pediatric settings. By knowing which tests are most sensitive and specific, nurses can assist in timely and accurate diagnosis, leading to better patient outcomes.