In children with physical abuse, when their inflicted trauma is burn injury, the MOST suggestive one is

Correct Answer: B

Rationale: In cases of physical abuse in children with burn injuries, the presence of patterned burns is the most suggestive of intentional harm. Patterned burns indicate that the injury was caused by a specific object or instrument, pointing towards inflicted trauma rather than accidental injury. This is crucial in identifying cases of abuse and taking appropriate actions to protect the child. The other options are incorrect because: A) Presence of splash marks is more indicative of accidental burns, like scalds from hot liquids. C) Unclear borders of burns are more likely to be seen in accidental burns where the heat distribution is uneven. D) Stocking/glove distribution is characteristic of immersion burns, which can be accidental in nature. Educationally, understanding the specific indicators of intentional burns in children is vital for healthcare professionals working with pediatric patients. Recognizing these signs can lead to early intervention and protection of vulnerable children from further harm. It is essential to be thorough in assessing and differentiating accidental from inflicted injuries to ensure the safety and well-being of pediatric patients.

Correct Answer: D

Rationale: The correct answer is D) ABO incompatibility with continued hemolysis. In this case, the infant's ABO blood type is incompatible with the mother's blood type, leading to hemolysis of the infant's red blood cells. This results in hyperbilirubinemia, pallor, and apathy due to anemia from ongoing hemolysis. The presence of a systolic ejection murmur and tachycardia are signs of anemia and increased cardiac output to compensate for decreased oxygen-carrying capacity. Option A) Anemia of chronic disease is unlikely in this scenario as the infant's symptoms are more consistent with acute hemolysis rather than a chronic disease process. Option B) Cholestasis secondary to neonatal hepatitis typically presents with jaundice and liver function abnormalities, which are not prominent features in this case. Option C) Hereditary spherocytosis would present with jaundice, anemia, and a positive family history, which are not described in the scenario. Understanding neonatal jaundice causes is crucial in pediatric nursing. ABO incompatibility is a common cause of neonatal jaundice, requiring prompt recognition and management to prevent complications such as kernicterus. Nurses must be able to recognize clinical manifestations and risk factors to provide appropriate care and education to families. This case highlights the importance of understanding hemolytic diseases in newborns and the need for close monitoring and interventions to manage complications effectively.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Administration of local anesthetic into the fetal scalp. The administration of local anesthetic into the fetal scalp is a common procedure during delivery to provide pain relief for the mother during an episiotomy or vacuum/forceps-assisted delivery. This procedure does not directly impact the baby's respiratory effort, muscle tone, or color at birth. A) Prolapsed umbilical cord can lead to decreased oxygen supply to the baby during delivery, causing cyanosis and respiratory distress. B) Central nervous system trauma during delivery can result in neurological deficits affecting the baby's respiratory and muscle tone. C) Administration of morphine to the mother can cross the placenta and depress the baby's respiratory drive, causing respiratory depression in the newborn. Educationally, understanding the potential complications of labor and delivery on the neonate is crucial for pediatric nurses. Recognizing the signs of distress in a newborn and understanding the potential causes can help nurses provide timely and appropriate interventions to ensure the best outcomes for both the newborn and the mother.

Correct Answer: D

Rationale: In pediatric nursing, understanding neonatal jaundice is crucial. Direct-reacting hyperbilirubinemia on the 5th day of life suggests an obstructive cause of jaundice. Gilbert disease is an unconjugated hyperbilirubinemia disorder due to a deficiency in the enzyme UDP-glucuronosyltransferase. This enzyme is responsible for conjugating bilirubin in the liver. Therefore, it is not associated with direct-reacting hyperbilirubinemia. Option A, cystic fibrosis, is incorrect as it can present with meconium ileus and subsequent liver involvement leading to jaundice. Option B, galactosemia, is incorrect due to the accumulation of galactose-1-phosphate, leading to liver damage and jaundice. Option C, neonatal hepatitis, can cause direct-reacting hyperbilirubinemia due to liver inflammation. Understanding the different causes of neonatal jaundice is essential for nurses caring for newborns. Recognizing the specific characteristics of each condition helps in prompt diagnosis and appropriate management. This knowledge ensures the well-being of neonates and highlights the importance of comprehensive pediatric nursing education.

Correct Answer: B

Rationale: The correct answer is B) Sudden overwhelming worries. This behavior is not necessarily a common feature in many psychiatric illnesses, unlike the other options provided. Eating very little (option A) can be a symptom of various psychiatric disorders such as anorexia nervosa or depression. Feeling sad or withdrawn (option C) is a hallmark of conditions like major depressive disorder or post-traumatic stress disorder. Throwing up (option D) can be a manifestation of certain disorders like bulimia nervosa or generalized anxiety disorder. In the context of pediatric nursing, understanding the behavioral symptoms associated with different psychiatric illnesses is crucial for early identification and intervention. By recognizing these behaviors, healthcare providers can provide appropriate support and treatment to children and adolescents experiencing mental health challenges. It is important to differentiate between normal developmental behaviors and those that may indicate an underlying psychiatric condition to ensure comprehensive care for pediatric patients.