Jaundice is most likely to be physiologic in a term infant in which of the following situations?

Correct Answer: B

Rationale: In pediatric nursing, understanding jaundice in newborns is crucial. The correct answer is B) Serum bilirubin level increasing less than 5 mg/dL in the first 48-72 hours. This is indicative of physiologic jaundice, a common and benign condition in newborns due to the immature liver processing bilirubin. Physiologic jaundice typically appears after 24 hours of life, peaks around day 3-4, and resolves by day 7-10. Option A is incorrect as jaundice within 24 hours is more likely to be pathologic. Option C is wrong because a direct serum bilirubin greater than 1 mg/dL is concerning for pathology. Option D is incorrect as jaundice appearing after day 7 is outside the typical time frame for physiologic jaundice. Educationally, it's important for pediatric nurses to grasp the timing, pattern, and risk factors for jaundice in newborns to differentiate between physiologic and pathologic causes. Monitoring bilirubin levels, assessing clinical signs, and knowing when to intervene are essential skills to ensure optimal care for neonates.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Pneumothorax. A preterm delivery at 7 weeks' gestation puts the infant at risk for respiratory distress due to underdeveloped lungs. Pneumothorax can occur when air leaks into the pleural space, leading to lung collapse and respiratory distress. This condition is common in preterm infants due to their fragile lung structure. Option B) Respiratory distress syndrome is a common condition in preterm infants, but in this case, the presentation suggests a sudden onset of respiratory distress, which is more indicative of pneumothorax. Option C) Patent ductus arteriosus is a cardiac condition that typically presents with a continuous murmur and is less likely to cause sudden respiratory distress. Option D) Group B streptococcal sepsis may present with respiratory symptoms, but it is less likely to cause acute respiratory distress in this case. Educationally, understanding the differential diagnosis of respiratory distress in preterm infants is crucial for pediatric nurses. Recognizing the signs and symptoms of pneumothorax, such as sudden onset respiratory distress and decreased breath sounds, enables prompt intervention and can prevent further complications in neonatal care. It is essential for nurses to be adept at assessing and managing respiratory issues in preterm infants to ensure positive patient outcomes.

Correct Answer: B

Rationale: Polycythemia is a condition characterized by an elevated red blood cell count. The correct answer, option B, "Intrauterine growth retardation," is not associated with polycythemia. In fact, polycythemia is more commonly linked with large-for-gestational-age infants due to increased blood volume. Option A, "Hyperviscosity," is associated with polycythemia as the increased number of red blood cells can lead to thicker blood consistency. Option D, "Twin-twin transfusion syndrome," is also related to polycythemia, as it involves an unequal blood flow between twins during pregnancy, potentially causing polycythemia in one twin. In an educational context, understanding the associations of polycythemia is crucial for pediatric nurses as they care for infants who may be affected by this condition. Recognizing the signs and symptoms of polycythemia and understanding its potential complications can aid in providing appropriate care and interventions for affected infants.

Correct Answer: D

Rationale: Rumination disorder is characterized by the repeated regurgitation and re-chewing of food, which leads to weight loss, malnutrition, and other health issues. The false statement in this question is option D: "It can resolve spontaneously." The correct answer is D because rumination disorder typically does not resolve spontaneously. It requires intervention and treatment by healthcare professionals, including pediatric nurses, to address the underlying causes and provide support to the child and their family. Option A, "It is only seen in infants," is incorrect because rumination disorder can occur in both infants and older children. It is not limited to a specific age group. Option B, "It runs a chronic course," is incorrect because rumination disorder can be successfully treated with early identification and intervention. It does not necessarily have to run a chronic course if addressed promptly. Option C, "It results from neglect," is incorrect because rumination disorder is a complex condition with various potential causes, including medical, psychological, and environmental factors. While neglect could be a contributing factor in some cases, it is not the sole cause of rumination disorder. In an educational context, it is important for pediatric nurses to understand the nuances of rumination disorder to provide comprehensive care to patients. By knowing the accurate information about the disorder, nurses can effectively assess, intervene, and support children and families affected by rumination disorder. Early recognition and appropriate treatment can improve outcomes and quality of life for children with this condition.

Correct Answer: A

Rationale: Breath-holding spells are a common phenomenon in pediatric populations, especially in toddlers and preschool-aged children. The best explanation for breath-holding spells being a manifestation of iron deficiency anemia (Option A) is due to the fact that these spells are often associated with anemia, and correcting the anemia can lead to a reduction or resolution of the spells. Iron deficiency can lead to decreased oxygen carrying capacity in the blood, which can trigger these spells in susceptible children. Option B, stating that breath-holding spells are a type of seizure, is incorrect. While breath-holding spells can sometimes resemble seizures due to the temporary loss of consciousness, they are not caused by abnormal electrical activity in the brain like seizures are. Option C, describing breath-holding spells as expressed by a brief tonic movement, is also incorrect. Breath-holding spells are characterized by a child holding their breath in response to a triggering event, not by tonic movements. Option D, claiming that breath-holding spells resolve by age 5, is not entirely accurate. While many children do outgrow these spells by age 5, some may continue to experience them beyond this age. It is not a definitive timeline for resolution. In an educational context, understanding the underlying causes of breath-holding spells, such as iron deficiency anemia, is crucial for pediatric nurses. By recognizing the connection between anemia and these spells, nurses can provide appropriate interventions such as iron supplementation and education for parents on how to manage and prevent these episodes. This knowledge enables nurses to offer comprehensive care to pediatric patients experiencing breath-holding spells.