One of the following can cause thrombocytopenia with decreased megakaryocytes in bone marrow:

Correct Answer: B

Rationale: In this question, the correct answer is B) Aplastic anemia. Aplastic anemia is a condition characterized by a decrease in all three blood cell types (red blood cells, white blood cells, and platelets) due to bone marrow failure. Thrombocytopenia, which is a low platelet count, can occur in aplastic anemia due to decreased production of megakaryocytes in the bone marrow, leading to a reduction in platelet formation. Option A) ITP (Idiopathic Thrombocytopenic Purpura) is characterized by a decrease in platelet count due to immune destruction of platelets, not decreased production in the bone marrow. Option C) Hypersplenism is a condition where the spleen sequesters and destroys blood cells, leading to a decrease in their circulating levels, but it does not directly affect megakaryocyte production in the bone marrow. Option D) DIC (Disseminated Intravascular Coagulation) is a condition where there is widespread activation of clotting factors leading to both thrombosis and bleeding. While DIC can cause thrombocytopenia, it does not specifically involve decreased megakaryocytes in the bone marrow. Educationally, understanding the different causes of thrombocytopenia is crucial in pediatric nursing practice. Knowing the pathophysiology behind each condition helps nurses in making accurate clinical assessments and providing appropriate interventions. Aplastic anemia is a serious condition that requires prompt recognition and management to prevent complications related to low platelet counts, such as bleeding. This knowledge is essential for nurses caring for pediatric patients with hematologic disorders.

Correct Answer: B

Rationale: The correct answer is B) 4 months. Educational Rationale: At 2 months of age, infants are just beginning to develop their visual abilities and hand-eye coordination. It is around the age of 4 months when infants start to grasp objects intentionally and show interest in exploring items through touch and sound. By giving a 2-month-old a rattle, they may not yet have the motor skills or cognitive development to fully engage with the toy. Providing the rattle at 4 months allows the infant to start practicing their grasping skills, enhancing their sensory exploration, and promoting cognitive development through cause-and-effect relationships. It also encourages the development of fine motor skills and hand coordination, which are important for later developmental milestones like self-feeding and writing. Option A) 2 months is incorrect because infants at this age are still developing their basic reflexes and are not yet ready for intentional play activities with objects like rattles. Options C) 7 months and D) 9 months are also incorrect as by this age, infants have already developed the ability to grasp objects and explore their environment actively. Waiting until 7 or 9 months to introduce a rattle may delay the child's opportunities for sensory and motor skill development during the critical earlier months. In pediatric nursing, understanding developmental milestones and appropriate play activities is crucial for guiding parents on how to support their child's growth and learning. By providing accurate information on when to introduce toys like rattles, nurses can empower parents to engage effectively with their infants, promoting healthy development and bonding.

Correct Answer: B

Rationale: The correct answer is B. When introducing solid foods to infants, it is important to introduce one food item at a time, with intervals of 4 to 7 days between each new food. This allows for the identification of any potential food allergies or intolerances. It is important to proceed gradually and monitor for any adverse reactions.

Correct Answer: D

Rationale: In this pediatric nursing certification practice question regarding urethritis, the correct answer is D) N.gonorrhoeae is one of the most commonly identified pathogens. This statement is NOT true because N.gonorrhoeae is actually one of the less common pathogens associated with urethritis, with Chlamydia trachomatis being the most common causative organism. Option A is true because urethritis can present with meatal pruritus, which is itching around the opening of the urethra. Option B is also true as a significant percentage of males with urethritis are asymptomatic, which highlights the importance of screening in high-risk populations. Option C is vague and incomplete. Educationally, understanding the etiology and clinical presentation of urethritis is crucial for pediatric nurses. By knowing that Chlamydia trachomatis is the most common pathogen causing urethritis, nurses can prioritize appropriate testing and treatment strategies. Additionally, recognizing the potential for asymptomatic cases emphasizes the importance of comprehensive screening protocols to prevent complications and transmission in pediatric populations.

Correct Answer: D

Rationale: In pediatric nursing, the evaluation for primary amenorrhea is a critical aspect of assessing the reproductive health of adolescent girls. The correct answer is D) 16 years. This age is considered appropriate for evaluation as it allows for the consideration of a wider range of normal variations in the onset of menstruation. Option A) 12 years is too early for evaluation as many girls may not have reached menarche by this age, and it is within the normal range of variation. Option B) 13 years is also early for evaluation as the onset of menstruation can vary widely in adolescents. Option C) 14 years is still premature for evaluation as some girls may experience delayed menarche without any underlying pathology. It is important for pediatric nurses to understand the normal developmental variations in adolescents to avoid unnecessary interventions or anxiety for both the patient and their families. By waiting until the age of 16 for evaluation of primary amenorrhea, healthcare providers can ensure a more accurate diagnosis and appropriate management of any underlying conditions. This knowledge is crucial for providing holistic and evidence-based care to adolescent patients.