In treatment of hypernatremia, the maximum accepted rate of drop of serum sodium per 24 hours?

Correct Answer: B

Rationale: The correct answer is B) 12 mmol/L. In the treatment of hypernatremia, it is crucial to correct the elevated serum sodium levels gradually to prevent complications such as cerebral edema. A rapid decrease in serum sodium levels can lead to osmotic demyelination syndrome, a severe neurological disorder. The recommended maximum rate of correction is around 8-12 mmol/L per 24 hours. Option A) 8 mmol/L is lower than the recommended rate of correction for hypernatremia. It may be too slow to effectively treat the condition, especially in severe cases where a more rapid correction is necessary. Option C) 16 mmol/L and Option D) 20 mmol/L exceed the safe rate of correction for hypernatremia. Rapidly decreasing serum sodium levels can lead to serious neurological complications, outweighing the benefits of correcting hypernatremia. In an educational context, it is essential for pediatric nurses to understand the delicate balance required when treating electrolyte imbalances in children. By adhering to the recommended guidelines for correcting hypernatremia, nurses can ensure safe and effective care for pediatric patients, minimizing the risk of adverse outcomes associated with rapid electrolyte shifts.

Correct Answer: C

Rationale: In this question, the correct answer is C) Dilute artificial formula. Total body sodium depletion occurs when there is an inadequate amount of sodium in the body compared to the amount of water. Dilute artificial formula can lead to total body sodium depletion in infants due to the low sodium content in the formula. A) SIADH (syndrome of inappropriate antidiuretic hormone) is associated with water retention, not sodium depletion. B) Psychogenic polydipsia is excessive thirst leading to water intake but does not directly relate to sodium depletion. D) Nephrotic syndrome involves protein loss in the urine but not necessarily total body sodium depletion. Educationally, understanding the relationship between sodium intake and body balance is crucial in pediatric nursing. Nurses must be able to identify the causes and symptoms of sodium imbalances in children to provide appropriate care and interventions. Monitoring sodium levels in infants on formula is essential to prevent complications related to total body sodium depletion.

Correct Answer: B

Rationale: The correct answer is B) Medullary relapse. In acute leukemia, medullary relapse is the most common type of relapse. This is because leukemia primarily affects the bone marrow where blood cells are produced. Medullary relapse refers to the recurrence of leukemia in the bone marrow. Option A) Clinical relapse is incorrect because clinical relapse is a broader term that encompasses various types of relapse, including medullary, CNS, and testicular relapse. It does not specify the specific location of the relapse. Option C) CNS relapse is incorrect because while relapse can occur in the central nervous system (CNS), it is less common than medullary relapse in acute leukemia. Option D) Testicular relapse is incorrect because this type of relapse is specific to leukemia spreading to the testicles, which is less common than medullary relapse. In an educational context, understanding the types of relapse in leukemia is crucial for pediatric nurses caring for children with this condition. Recognizing the most common type of relapse, which is medullary relapse, helps nurses in monitoring and managing the disease effectively. It also highlights the importance of regular assessments and follow-up to detect relapse early and initiate appropriate interventions.

Correct Answer: B

Rationale: In pediatric nursing, understanding the various causes of purpura is crucial for accurate assessment and diagnosis. The correct answer, B) Anaphylactoid purpura, is the commonest cause of non-thrombocytopenic purpura in children. This condition, also known as Henoch-Schönlein purpura, is characterized by immune-mediated inflammation of small blood vessels, leading to purpuric rash, joint pain, abdominal pain, and kidney involvement. Option A) Disseminated intravascular hemolysis (DIC) is incorrect because it is a cause of thrombocytopenic purpura due to platelet consumption in the coagulation process. Option C) Acute lymphoblastic leukemia is incorrect as it is associated with thrombocytopenia rather than non-thrombocytopenic purpura. Option D) Hypersplenism is also incorrect because it results in splenic sequestration of platelets leading to thrombocytopenia. Educationally, this question highlights the importance of recognizing different types of purpura in children and understanding the underlying pathophysiology to provide appropriate care. Nurses should be able to differentiate between thrombocytopenic and non-thrombocytopenic purpura to guide treatment interventions and ensure optimal outcomes for pediatric patients.

Correct Answer: D

Rationale: The correct answer to the question is D) Mixed cellularity. In classic Hodgkin disease, the most common histological subtype in children is mixed cellularity. This subtype is characterized by the presence of numerous inflammatory cells, including lymphocytes, plasma cells, eosinophils, and macrophages, along with Reed-Sternberg cells. Nodular sclerosis (option A) is another histological subtype of classic Hodgkin disease but is more commonly seen in adolescents and young adults rather than in children. Lymphocyte predominance (option B) and lymphocyte depletion (option C) are less common subtypes of Hodgkin disease and are not typically seen as frequently in children as mixed cellularity. In an educational context, understanding the different histological subtypes of Hodgkin disease is crucial for healthcare professionals working with pediatric patients. Recognizing the most common subtype in children, which is mixed cellularity, helps in accurate diagnosis, treatment planning, and prognosis assessment for pediatric patients with Hodgkin disease. This knowledge is essential for pediatric nurses to provide comprehensive care and support to children and their families facing this diagnosis.