Initial treatment of rheumatic fever with severe carditis and congestive heart failure includes all of the following Except:

Correct Answer: C

Rationale: In the initial treatment of rheumatic fever with severe carditis and congestive heart failure, the correct answer is C) Acetylsalicylic acid 100 mg/kg/day in 4 divided doses. This is because the use of salicylates like aspirin is contraindicated in patients with acute rheumatic fever due to the risk of causing Reye's syndrome, a rare but serious condition that affects the brain and liver. Option A) Benzathine benzyl penicillin 1.2 mega unit is essential in the treatment of rheumatic fever to eradicate the streptococcal infection that triggers the disease. Option B) Complete bed rest is important to reduce the workload on the heart and prevent further complications. Option D) Prednisolone 2 mg/kg/day in 3 divided doses may be used in cases of severe carditis but is not the initial treatment of choice. In the context of pediatric nursing education, it is crucial for students to understand the rationale behind treatment choices for rheumatic fever to provide safe and effective care to pediatric patients. Understanding the contraindications and appropriate use of medications is essential in preventing potential complications and promoting positive patient outcomes.

Correct Answer: B

Rationale: In neonates, apnea of prematurity is due to an immature central respiratory control system. This is the correct answer because premature infants often have underdeveloped neurological systems, including the centers in the brain that regulate breathing. Immature central respiratory control can lead to periods of apnea where the baby stops breathing temporarily. Option A, airway obstruction, is incorrect in the context of apnea of prematurity. While airway obstruction can cause breathing difficulties in infants, it is not the primary cause of apnea in premature babies. Option C, congenital heart disease, is also incorrect in this scenario. While congenital heart defects can lead to respiratory issues in infants, they are not the primary cause of apnea in premature neonates. Option D, neuromuscular disorders, is incorrect as well. While neuromuscular disorders can cause respiratory problems in infants, apnea of prematurity specifically refers to the immature respiratory control system in premature babies. Understanding the reasons behind apnea of prematurity is crucial for pediatric nurses to provide appropriate care and interventions for these vulnerable patients. By recognizing the underlying cause, nurses can implement strategies to support and monitor the infant's respiratory function effectively. This knowledge is essential in the neonatal intensive care unit (NICU) where premature infants are at higher risk for apnea episodes.

Correct Answer: C

Rationale: In this scenario, the most concerning diagnosis for a newborn presenting with delayed meconium passage, abdominal distension, and bilious vomiting is Hirschsprung disease (Option C). Hirschsprung disease is a congenital disorder where there is an absence of ganglion cells in segments of the colon, leading to functional obstruction. This condition can present with symptoms such as constipation, abdominal distension, and bilious vomiting, which are all evident in the case described. Option A, Meconium plug syndrome, is incorrect because although it can cause delayed meconium passage, it typically does not lead to bilious vomiting or abdominal distension as seen in the case. Option B, Cystic fibrosis, is incorrect as it primarily presents with respiratory and digestive issues, but not specifically with the symptoms described. Option D, Malrotation with volvulus, can also present with bilious vomiting and abdominal distension, but typically not with delayed meconium passage and is less common in newborns compared to Hirschsprung disease. In an educational context, understanding the distinguishing features of these conditions is crucial for pediatric nurses to provide prompt and appropriate care for neonates. Recognizing the symptoms and knowing the appropriate diagnostic and management steps for conditions like Hirschsprung disease can significantly impact patient outcomes. It highlights the importance of thorough assessment, critical thinking, and knowledge application in pediatric nursing practice.

Correct Answer: D

Rationale: In this scenario, the most likely diagnosis for a newborn presenting with excessive oral secretions and choking during the first feeding is D) Esophageal atresia. Esophageal atresia is a congenital condition where the esophagus does not fully develop, leading to a blockage that prevents proper swallowing and passage of food into the stomach. This results in excessive oral secretions and choking during feeding as the newborn is unable to swallow effectively. The other options are incorrect in this context: A) Choanal atresia: This condition involves blockage of the nasal passages, not related to feeding or oral secretions. B) Pyloric stenosis: This condition occurs in infants and involves the narrowing of the opening from the stomach to the small intestine, leading to projectile vomiting, not excessive oral secretions. C) Tracheoesophageal fistula: This is a connection between the trachea and esophagus, which can lead to choking and respiratory issues but typically manifests differently than esophageal atresia. Educationally, understanding common pediatric conditions like esophageal atresia is crucial for healthcare providers working with newborns to provide timely intervention and support. Recognizing the signs and symptoms of different conditions can help in prompt diagnosis and management, improving outcomes for pediatric patients.

Correct Answer: C

Rationale: In pediatric nursing, understanding croup is crucial as it is a common respiratory condition in children. The correct answer, option C, states that the incidence of croup is higher in females. This is incorrect because croup actually affects males more frequently than females. Option A is true as the most common organism causing croup is the parainfluenza virus. Option B is also accurate as the peak age group affected by croup is around 2 years old due to the narrowing of the airway in young children. Option D is also a common feature of croup as a strong family history of croup or upper respiratory infections can predispose a child to the condition. Educationally, understanding the demographics, common causes, and risk factors associated with croup is essential for pediatric nurses to provide effective care and education to both the child and their family. By knowing these details, healthcare providers can better recognize and manage croup, ultimately improving outcomes for pediatric patients.