Methylxanthines for the treatment of broncho-pulmonary dysplasia (BPD) have the following effects EXCEPT

Correct Answer: D

Rationale: In the treatment of broncho-pulmonary dysplasia (BPD), methylxanthines such as caffeine are commonly used due to their respiratory stimulant effects. The correct answer, option D, states that methylxanthines do not increase pulmonary vascular resistance (PVR). This is accurate because methylxanthines actually have a vasodilatory effect on the pulmonary vasculature, reducing PVR. Option A, increasing respiratory drive, is a known effect of methylxanthines. They stimulate the central nervous system, leading to an increase in respiratory rate and depth. Option B, decreasing apnea, is also a well-documented effect of methylxanthines as they help in reducing the incidence of apnea of prematurity in infants. Option C, improving diaphragmatic contractility, is not directly related to the effects of methylxanthines. While these medications primarily work by stimulating the respiratory centers in the brain, they do not have a direct effect on diaphragmatic contractility. In an educational context, understanding the effects of medications used in the treatment of respiratory conditions such as BPD is crucial for pediatric nurses. It allows for safe and effective administration of these drugs, as well as monitoring for both therapeutic effects and potential adverse reactions. This knowledge helps nurses provide comprehensive care to pediatric patients with respiratory issues and ensures optimal outcomes for these vulnerable populations.

Correct Answer: A

Rationale: In this question on pediatric nursing related to abnormally short cords, the correct answer is option A) Fetal hypotonia. Abnormally short cords are associated with fetal hypotonia because the lack of movement and muscle tone in the fetus can lead to decreased fetal activity which in turn may result in a shorter cord. Option B) Wrapping around fetal parts is incorrect because this is actually a common cause of fetal distress and complications during labor and delivery. When the cord wraps around the fetal parts, it can lead to decreased blood flow and oxygen supply to the fetus. Option C) Uterine constraint is incorrect as well because this can also contribute to complications during labor and delivery but is not directly related to the length of the umbilical cord. Option D) Oligohydramnios is incorrect as it refers to decreased amniotic fluid levels which can also impact fetal well-being but is not directly related to the length of the umbilical cord. In an educational context, understanding the implications of abnormally short cords is crucial for pediatric nurses as they care for infants and children. Recognizing the factors associated with abnormal cord length can help nurses identify potential risks and provide appropriate care and interventions to ensure optimal outcomes for both the mother and the baby.

Correct Answer: D

Rationale: Intrapartum antibiotics are administered to pregnant women during labor to prevent the transmission of Group B Streptococcus (GBS) to the newborn, which can lead to serious infections. The correct answer, option D, "Reduce the rates of late-onset GBS disease," is the most accurate statement regarding the use of intrapartum antibiotics. Administering antibiotics during labor has been shown to decrease the incidence of late-onset GBS disease, which occurs in newborns after the first week of life. Option A, "Reduce vertical transmission of GBS," is incorrect because intrapartum antibiotics aim to prevent the transmission during labor, not before birth. Option B, "Lessen neonatal morbidity after preterm rupture of membranes," is also incorrect as antibiotics in this context are primarily focused on GBS prevention rather than addressing preterm rupture of membranes. Option C, "Prevent perinatal transmission of GBS," is not the best choice as it is too broad and does not specifically address the impact on late-onset GBS disease. In an educational context, understanding the rationale behind administering intrapartum antibiotics is crucial for pediatric nurses to provide evidence-based care to pregnant women and newborns. By knowing the specific benefits of this intervention, nurses can effectively advocate for its use to promote the health and well-being of infants. It is essential for nurses to stay updated on current guidelines and recommendations regarding intrapartum antibiotic use to provide safe and quality care to pediatric patients.

Correct Answer: D

Rationale: The correct answer is D) Exposure to glucocorticoids during the first week of life. Necrotizing enterocolitis (NEC) is a serious condition in preterm infants where parts of the intestine undergo tissue death. Glucocorticoids, which are often used in preterm infants to help with lung maturation, can suppress the immune system and increase the risk of developing NEC due to impaired intestinal barrier function and altered immune response. Option A) Delivery by cesarean section is not the most important risk factor for NEC. While cesarean section delivery can impact the infant's gut microbiome, which may play a role in NEC development, it is not as significant as exposure to glucocorticoids. Option B) Breastfeeding is actually protective against NEC due to its benefits in promoting a healthy gut microbiome and providing immune factors that can reduce the risk of NEC. Option C) Apgar score, which assesses the newborn's overall condition at birth, is not directly linked to the development of NEC. While a low Apgar score may indicate a higher risk for various complications, it is not the most important risk factor for NEC. In an educational context, understanding the risk factors for NEC in preterm infants is crucial for healthcare providers working in neonatal care. By recognizing the significance of glucocorticoid exposure in increasing the risk of NEC, healthcare professionals can implement strategies to minimize this risk, such as judicious use of glucocorticoids and close monitoring of preterm infants for early signs of NEC. This knowledge is essential for providing optimal care and improving outcomes for vulnerable preterm infants.

Correct Answer: D

Rationale: In pediatric nursing, it is crucial to understand age-appropriate symptoms and behaviors. In this case, the correct answer is D) sexual indifference, as it is least likely to occur in a 5-year-old girl with unexplained physical complaints. At this age, children are typically not exhibiting signs of sexual indifference as it is not a developmentally appropriate behavior. Option A) headache, abdominal pain, and Option B) back pain and chest pain are common physical complaints in children and could indicate various health issues but are more likely to occur than sexual indifference in a 5-year-old. Option C) nausea, vomiting, and diarrhea are also common symptoms in children and can be indicative of various medical conditions, but again, they are more likely to occur than sexual indifference in a 5-year-old. Educationally, understanding age-appropriate symptoms and behaviors in pediatric patients is essential for nurses to provide appropriate care and determine the underlying cause of their complaints. By recognizing what is developmentally normal and abnormal for different age groups, healthcare providers can more effectively assess and treat pediatric patients.