Nurse Victoria is teaching the parents of a school-age child. Which teaching topic should take priority?

Correct Answer: A

Rationale: In the context of pediatric cardiovascular disorders, preventing accidents should take priority when teaching parents of a school-age child. Children with cardiovascular issues may have physical limitations that put them at a higher risk for accidents. Educating parents about safety measures, such as childproofing the home, supervising activities, and recognizing signs of distress, is crucial in preventing potential harm to the child. Keeping a night light on to allay fears (Option B) is important for general child development but is not as critical as preventing accidents in the case of a child with cardiovascular disorders. Explaining the normalcy of fears about body integrity (Option C) and encouraging the child to dress without help (Option D) are also important aspects of child development but do not directly address the safety concerns specific to children with cardiovascular disorders. In an educational context, prioritizing topics based on the specific needs of children with medical conditions helps parents better understand how to provide a safe and nurturing environment for their child. By emphasizing accident prevention, nurses can empower parents to take proactive steps in ensuring their child's well-being while managing their cardiovascular condition.

Correct Answer: C

Rationale: The correct answer is C) “Leave the diaper off while the infant sleeps.” Rationale: Leaving the diaper off while the infant sleeps allows for increased airflow, which can help in healing the diaper rash. This practice reduces moisture exposure to the affected area, aiding in the resolution of the rash. Moreover, the absence of a diaper during sleep can also prevent further irritation and promote faster healing. Option A) “Switch to cloth diapers until the rash is gone” is incorrect because while cloth diapers may reduce some irritation compared to disposable diapers, the key to healing a diaper rash lies in increasing airflow to the area, which can be achieved by leaving the diaper off. Option B) “Use baby wipes with each diaper change” is incorrect because using wipes at each diaper change can further irritate the rash due to the chemicals or fragrances present in the wipes. Instead, gentle cleansing with warm water and a soft cloth is recommended. Option D) “Offer extra fluids to the infant until the rash improves” is incorrect as increasing fluid intake will not directly impact the healing of the diaper rash. The focus should be on keeping the affected area clean, dry, and exposed to air as much as possible. Educational context: In pediatric nursing, understanding how to manage common issues like diaper rash is crucial for providing comprehensive care to infants. Educating parents on proper diaper rash management empowers them to take effective measures at home to promote healing and prevent recurrence. It is essential for nurses to provide evidence-based recommendations to support optimal infant skin health and overall well-being.

Correct Answer: A

Rationale: In pediatric nursing, monitoring for signs of hydrocephalus is crucial, especially in infants with conditions like spina bifida that may predispose them to this condition. Measuring head circumference is the most important technique in recognizing possible hydrocephalus in infants. Hydrocephalus causes an abnormal accumulation of cerebrospinal fluid within the brain's ventricles, leading to increased head size. Measuring head circumference regularly helps track any abnormal growth patterns indicative of hydrocephalus development. Obtaining a skull X-ray is not typically used to diagnose hydrocephalus in infants. It may show abnormalities related to conditions like spina bifida but is not the primary method for hydrocephalus diagnosis. Performing a lumbar puncture is invasive and unnecessary for diagnosing hydrocephalus based on head circumference changes. MRI is a valuable diagnostic tool for confirming hydrocephalus, but it is not the initial step; measuring head circumference is a non-invasive, practical first-line approach in clinical settings. In an educational context, understanding the importance of assessing head circumference in infants with conditions like spina bifida is vital for early detection of potential complications like hydrocephalus. Nurses need to be trained to recognize subtle changes in head size and promptly escalate concerns to the healthcare team for further evaluation and management. This question underscores the significance of basic assessment skills in pediatric nursing and highlights the practical application of knowledge in clinical scenarios.

Correct Answer: A

Rationale: The correct answer is A) Squatting increases the return of venous blood back to the heart. In children with tetralogy of Fallot, there is a characteristic squatting posture adopted by the child during episodes of cyanosis or hypoxia. This position helps improve oxygenation by increasing systemic vascular resistance and decreasing right-to-left shunting of blood. By squatting, the child increases the return of venous blood to the heart, which can temporarily improve oxygen levels in the blood. Option B) Squatting decreases arterial blood flow away from the heart is incorrect because squatting actually increases venous return to the heart, not arterial blood flow away from it. Option C) Squatting is a common resting position when a child is tachycardic is incorrect as squatting in children with tetralogy of Fallot is more related to improving oxygenation rather than being solely due to tachycardia. Option D) Squatting increases the workload of the heart is incorrect because while squatting does increase venous return to the heart, it does not necessarily increase the workload of the heart in this specific context of tetralogy of Fallot. Understanding the rationale behind why children with tetralogy of Fallot squat can help healthcare providers educate parents and caregivers on how to manage and respond to episodes of cyanosis or hypoxia in these children effectively. By knowing the correct response, nurses can provide accurate and evidence-based information to parents, ultimately improving the care and outcomes for children with congenital heart defects.

Correct Answer: A

Rationale: The correct answer is A) Inflammation weakens blood vessels, leading to an aneurysm. In Kawasaki disease, there is widespread inflammation in the blood vessels, particularly affecting the coronary arteries. This inflammation can weaken the vessel walls, leading to the formation of aneurysms. Aneurysms in the coronary arteries can increase the risk of blood clot formation and potentially result in serious complications like myocardial infarction or sudden cardiac death. Option B) Increased lipid levels leading to the development of atherosclerosis is incorrect because Kawasaki disease is primarily characterized by inflammation rather than lipid abnormalities. Option C) Untreated disease causing mitral valve stenosis is incorrect as mitral valve stenosis is not a typical complication of Kawasaki disease. It primarily affects the coronary arteries. Option D) Altered blood flow increasing cardiac workload with resulting heart failure is incorrect as the primary concern in Kawasaki disease is the development of coronary artery abnormalities rather than heart failure due to altered blood flow. Educationally, it is important for nurses to understand the pathophysiology of Kawasaki disease to provide accurate information to parents and ensure appropriate care and monitoring for affected children. By knowing the potential complications, nurses can work collaboratively with the healthcare team to prevent serious cardiac outcomes in children with Kawasaki disease.