In ITP, platelet transfusion is indicated if platelet count is less than:

Correct Answer: A

Rationale: In Immune Thrombocytopenic Purpura (ITP), platelet transfusion is indicated when the platelet count is critically low to prevent bleeding complications. The correct answer is A) 10,000/mm3. When the platelet count drops below 10,000/mm3, there is a significantly increased risk of spontaneous bleeding, especially in critical areas such as the brain. Option B) 30,000/mm3 is too high of a threshold for initiating platelet transfusion in ITP. Waiting for the platelet count to drop to this level may result in unnecessary bleeding episodes. Option C) 40,000/mm3 and Option D) 50,000/mm3 are even higher thresholds and waiting until these levels may result in serious bleeding complications for the patient with ITP. From an educational standpoint, understanding the appropriate indications for platelet transfusion in ITP is crucial for pediatric nurses. It ensures timely and appropriate interventions to prevent life-threatening bleeding in these vulnerable patients. Nurses need to be knowledgeable about the specific platelet count thresholds to deliver safe and effective care to children with ITP.

Correct Answer: D

Rationale: Arthralgia without objective evidence (swelling, redness) is a minor criterion in acute rheumatic fever. Other minor criteria include fever, elevated acute-phase reactants (ESR, CRP), and prolonged PR interval. The major criteria include carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules.

Correct Answer: D

Rationale: In this scenario, the most likely diagnosis for a cyanosed 1-year-old infant with known heart disease is Tricuspid atresia (Option D). Tricuspid atresia is a congenital heart defect where the tricuspid valve is missing or abnormally developed. This leads to mixing of oxygenated and deoxygenated blood, resulting in cyanosis. Option A, Atrial septal defect, typically presents with a fixed splitting of S2 and is associated with a normal oxygen saturation. Option B, Coarctation of the aorta, would present with high blood pressure in the upper extremities and weak pulses in the lower extremities, not cyanosis. Option C, Patent ductus arteriosus, usually causes a continuous murmur and is not typically associated with cyanosis. Educationally, understanding the characteristic signs and symptoms of different congenital heart defects is crucial for pediatric nursing practice. Recognizing cyanosis in a child can be a critical indicator of a serious underlying heart condition. By knowing the specific features of each condition, nurses can provide timely and appropriate care, potentially preventing complications and improving outcomes for pediatric patients with heart disease.

Correct Answer: C

Rationale: In infants with chronic heart failure, clinical presentations can be subtle yet crucial to recognize. The correct answer, option C, "Acute weight gain due to edema formation," is not typically a typical presentation of chronic heart failure in infancy. In pediatric patients with heart failure, they often present with feeding difficulty (option A) due to poor cardiac output affecting their energy levels and stamina. Excessive sweating with feeding (option B) can occur due to increased work of breathing and effort required during feeding. Nocturnal irritability and cough (option D) may be seen in infants with heart failure due to increased respiratory effort when lying down. Understanding the clinical presentations of chronic heart failure in infants is vital for pediatric nurses as prompt recognition and intervention can significantly impact patient outcomes. By knowing the signs and symptoms, nurses can collaborate with the healthcare team to provide appropriate care and prevent potential complications. It is important to differentiate these symptoms from common infant issues to ensure timely diagnosis and management of heart failure. Regular assessments and monitoring are key components of pediatric nursing care to detect early signs of deterioration and optimize outcomes for pediatric patients with heart failure.

Correct Answer: D

Rationale: In Tetralogy of Fallot, the correct answer is D) Commonly associated with heart failure. This is because Tetralogy of Fallot is a congenital heart defect characterized by four main abnormalities in the heart's structure, including a ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy. These abnormalities can lead to decreased blood flow to the lungs and decreased oxygen levels in the blood, causing cyanosis and clubbing of the fingers. Pulmonary oligemia in chest X-ray (option A) is seen in Tetralogy of Fallot due to reduced blood flow to the lungs. Central cyanosis and clubbing (option B) are common clinical manifestations of Tetralogy of Fallot due to the mixing of oxygen-poor and oxygen-rich blood. Basal ejection systolic murmur and single second heart sound (option C) are also characteristic findings in Tetralogy of Fallot due to the pulmonary stenosis and overriding aorta. Understanding these key clinical features and associations is crucial for nurses caring for pediatric patients with congenital heart defects like Tetralogy of Fallot, as early recognition and appropriate management are essential for optimizing outcomes and preventing complications.