In an arrested child with ventricular fibrillation, the first maneuver to do immediately is

Correct Answer: A

Rationale: In a pediatric patient with ventricular fibrillation, the immediate action should be to provide a DC shock (option A). This is because ventricular fibrillation is a life-threatening arrhythmia that requires prompt defibrillation to restore normal sinus rhythm. Defibrillation helps to depolarize the heart muscle and allows the sinoatrial (SA) node to regain control of the heart's rhythm. Option B, giving anti-arrhythmic drugs, is not the first-line treatment for ventricular fibrillation in a pediatric patient. While anti-arrhythmic drugs may be used as adjunct therapy, they are not as effective as immediate defibrillation in this emergency situation. Option C, giving Epinephrine, is important in pediatric advanced life support protocols but should come after defibrillation in the management of ventricular fibrillation. Option D, giving Atropine, is used to treat symptomatic bradycardia and not ventricular fibrillation. In an educational context, it is crucial for pediatric nurses to understand the priority actions in managing pediatric cardiac emergencies like ventricular fibrillation. Quick and accurate decision-making can significantly impact patient outcomes in such critical situations. Nurses should be trained in recognizing arrhythmias, understanding the appropriate interventions, and being prepared to respond swiftly to provide life-saving care to pediatric patients experiencing cardiac emergencies.

Correct Answer: C

Rationale: The correct answer is C) Ventricular septal defect. In pediatric nursing, understanding common congenital heart diseases is crucial. A ventricular septal defect is the most common acyanotic heart defect in children. This defect involves an opening in the septum between the two ventricles, allowing blood to flow from the left ventricle to the right ventricle, leading to increased pulmonary blood flow and potential heart failure over time. Coarctation of the aorta (A) is a narrowing of the aorta, which can lead to high blood pressure and other complications, but it is not the most common acyanotic heart defect. Atrial septal defect (B) involves a hole in the atrial septum, leading to abnormal blood flow between the atria. Pulmonary valve stenosis (D) is a narrowing of the pulmonary valve, causing obstruction to blood flow from the right ventricle to the pulmonary artery. Educationally, knowing the prevalence and characteristics of different congenital heart diseases helps nurses in early identification, appropriate intervention, and ongoing management of pediatric patients with these conditions. Understanding the pathophysiology of each defect is essential for providing safe and effective care to children with congenital heart diseases.

Correct Answer: A

Rationale: In Tetralogy of Fallot (TOF), the correct statement is A) Squatting is a common clinical presentation. This is because squatting helps decrease the systemic vascular resistance, which can improve blood flow to the lungs in TOF patients, relieving cyanosis. This physiological response is known as the squatting maneuver and is a characteristic finding in TOF. Option B) Hypercyanotic spells in TOF are managed by increasing systemic vascular resistance, typically with methods like knee-chest position or administration of oxygen, not IV digoxin. IV digoxin is not recommended in this scenario. Option C) Brain abscess is not a common neurological complication in TOF. Complications like hypoxic brain injury or developmental delays due to chronic hypoxemia are more likely. Option D) The typical murmur heard in TOF is a systolic ejection murmur, not a pansystolic murmur. Understanding the characteristic findings in TOF is crucial for nurses caring for pediatric patients with this congenital heart defect. Recognizing these clinical presentations and appropriate interventions are essential for providing safe and effective care to these children.

Correct Answer: C

Rationale: Wilson's disease is an autosomal recessive disorder characterized by the accumulation of copper in the liver, brain, and other tissues. The correct answer is C) Low ceruloplasmin in serum. Ceruloplasmin is a protein responsible for transporting copper in the blood, and in Wilson's disease, there is a decrease in ceruloplasmin levels due to impaired copper excretion, leading to copper buildup. Option A) Brushfield spots are not associated with Wilson's disease but are seen in individuals with Down syndrome. Option B) Autosomal dominant disorder is incorrect as Wilson's disease follows an autosomal recessive pattern of inheritance. Option D) High ceruloplasmin in serum is also incorrect as the hallmark of Wilson's disease is low ceruloplasmin levels. In an educational context, understanding the key clinical manifestations and diagnostic markers of Wilson's disease is crucial for pediatric nurses to provide safe and effective care to pediatric patients. By knowing that low ceruloplasmin levels are indicative of Wilson's disease, nurses can collaborate with healthcare providers to ensure timely diagnosis and management of this potentially life-threatening condition.

Correct Answer: C

Rationale: Encopresis is a condition where a child voluntarily passes stool in inappropriate places, such as in their underwear. This behavior is usually not due to a medical issue but rather psychological factors like stress or resistance to toilet training. Therefore, option C is correct as it directly describes the characteristic feature of encopresis. Option A, rabbit pellets form of stool, describes a possible appearance of stool but does not define encopresis. Option B, diarrhea, is a completely different bowel issue characterized by loose, watery stools. Option D, hard infrequent painful defecation, describes constipation, which is also distinct from encopresis. In an educational context, understanding the correct definition of encopresis is crucial for pediatric nurses to provide appropriate care and support to children and their families. By recognizing the behavior patterns associated with encopresis, nurses can tailor interventions to address the underlying causes and help the child overcome this condition effectively.