Increased anion gap is seen in:

Correct Answer: A

Rationale: In this question regarding increased anion gap, the correct answer is A) Uraemia. An increased anion gap typically indicates the presence of unmeasured anions in the blood, such as lactate, ketones, or sulfates. Uraemia, which refers to the presence of excessive urea and other nitrogenous waste compounds in the blood due to kidney dysfunction, can lead to an increased anion gap. Option B) Starvation is incorrect because while it can lead to metabolic changes, it is not typically associated with an increased anion gap. Option C) Renal tubular acidosis is also incorrect as it is a condition where the kidneys are unable to acidify urine properly, but it does not directly cause an increased anion gap. Option D) Acetazolamide therapy is incorrect as well, as this medication is a carbonic anhydrase inhibitor and can lead to metabolic acidosis, but not specifically to an increased anion gap. Educationally, understanding the concept of anion gap is crucial in pharmacology and pediatric cardiovascular nursing as it helps in diagnosing and managing various conditions, such as metabolic acidosis. It is important for healthcare professionals to be able to interpret lab values accurately to provide optimal care for pediatric patients with cardiovascular issues.

Correct Answer: A

Rationale: In scabies, the correct answer is A) Itching is due to sensitization by the mite. This is because scabies is a parasitic infestation caused by the mite Sarcoptes scabiei that burrows into the skin, leading to an allergic reaction and intense itching as the body reacts to the presence of the mite and its products. Option B) Vesicles may be seen in children is incorrect because scabies typically presents as papules, burrows, and nodules rather than vesicles. Vesicles are more commonly associated with conditions like herpes simplex or varicella. Option C) The organism is easily demonstrated is incorrect because diagnosing scabies requires identifying mites, eggs, or fecal matter under a microscope, which can be challenging and may require multiple skin scrapings. Option D) Spread can occur through clothes and bedding is incorrect because scabies is primarily transmitted through direct skin-to-skin contact with an infested individual. While transmission through shared clothing or bedding is possible, it is less common compared to direct contact. Educationally, understanding the pathophysiology, clinical manifestations, and diagnostic criteria of scabies is crucial for healthcare providers, especially those working in pediatric settings. By knowing the correct information about scabies, healthcare professionals can accurately diagnose and manage this condition in pediatric patients, ensuring appropriate treatment and prevention strategies are implemented.

Correct Answer: D

Rationale: In pediatric cardiovascular nursing, understanding the manifestations of anorexia nervosa is crucial due to its impact on cardiac health. The correct answer, "D) Sinus bradycardia," is a recognized feature of anorexia nervosa. Sinus bradycardia is a common finding in individuals with severe malnutrition, such as in anorexia nervosa, as the body's response to conserve energy. Option A, "T-wave inversion on ECG," is not typically associated with anorexia nervosa. T-wave inversion can be seen in conditions like myocardial ischemia or electrolyte imbalances, but it is not a specific feature of anorexia nervosa. Option B, "Hypocholesterolemia," is not a typical feature of anorexia nervosa. In fact, individuals with anorexia nervosa often have dyslipidemia with decreased HDL levels due to altered lipid metabolism. Option C, "Peripheral edema," is also not a common finding in anorexia nervosa. Peripheral edema is more commonly associated with conditions like heart failure or nephrotic syndrome. Educationally, understanding the cardiac implications of anorexia nervosa is essential for pediatric nurses caring for patients with eating disorders. Recognizing signs like sinus bradycardia can prompt timely interventions and prevent further cardiac complications. Integrating this knowledge into practice ensures comprehensive care for pediatric patients with anorexia nervosa.

Correct Answer: A

Rationale: In pediatric cardiovascular nursing, understanding the indications for an exchange transfusion is crucial for providing safe and effective care to infants and children. The correct answer is A) ABO incompatibility. Rationale for A) ABO incompatibility: An exchange transfusion is indicated in cases of ABO incompatibility, a condition where the mother's blood type is different from the baby's, leading to hemolytic disease of the newborn. This can result in severe hemolysis and hyperbilirubinemia, requiring removal of the baby's blood and replacement with compatible donor blood to prevent complications such as kernicterus. Rationale for why others are wrong: B) Acute chest syndrome: Acute chest syndrome is a complication of sickle cell disease, not an indication for exchange transfusion. C) Sepsis: While sepsis may require blood transfusion, it is not a specific indication for an exchange transfusion. D) Polycythemia: Polycythemia is an excess of red blood cells and is not typically an indication for exchange transfusion unless it is causing significant complications. Educational context: Understanding the specific indications for exchange transfusion is essential in pediatric cardiovascular nursing to ensure appropriate and timely interventions for infants and children at risk of serious complications. ABO incompatibility is a high-yield topic in pediatric nursing that requires a thorough understanding of blood type compatibility and its implications for neonatal health. By knowing the correct indications for exchange transfusion, nurses can advocate for prompt treatment and improve outcomes for their pediatric patients.

Correct Answer: B

Rationale: In pediatric cardiovascular nursing, understanding Duchenne muscular dystrophy (DMD) is crucial. The correct answer in this scenario is option B: Features usually present before five years of age. This is because DMD is a genetic disorder that primarily affects young boys, with symptoms typically manifesting before the age of five. Option A, affecting the dystrophin gene, is a common characteristic of DMD. The absence of functional dystrophin protein is a key factor in the pathophysiology of this condition. Option C, frontal baldness, is not a typical feature of DMD. This distractor may lead to confusion if not properly understood. Option D, being part of the differential diagnosis in a floppy infant, is incorrect as DMD is not typically associated with floppy infant syndrome. Educationally, it is important for nurses to be able to recognize the early signs and symptoms of DMD in pediatric patients to facilitate timely diagnosis and intervention. Understanding the genetic basis of the condition and its typical presentation age are key components in providing comprehensive care to children with DMD. This knowledge enables nurses to support families, coordinate care with a multidisciplinary team, and implement appropriate interventions to optimize outcomes for these patients.