One of the following causes of anemia is associated with macrocytosis:

Correct Answer: D

Rationale: In pediatric nursing, understanding the causes of anemia is crucial for accurate diagnosis and effective treatment. In this case, the correct answer is D) Vitamin B12 deficiency, which is associated with macrocytosis. Macrocytosis refers to the presence of abnormally large red blood cells, which is a characteristic feature of Vitamin B12 deficiency anemia. Vitamin B12 plays a vital role in the production of red blood cells in the bone marrow. A deficiency in Vitamin B12 leads to ineffective erythropoiesis, resulting in the production of larger-than-normal red blood cells, hence macrocytosis. Now let's analyze why the other options are incorrect: - A) Sickle cell anemia: Sickle cell anemia is characterized by the presence of sickle-shaped red blood cells, not macrocytosis. - B) Aplastic anemia: Aplastic anemia is a condition where the bone marrow does not produce enough blood cells, but it is not typically associated with macrocytosis. - C) Congenital spherocytosis: This condition involves abnormal red blood cell shape, leading to hemolysis, but not macrocytosis. Educationally, understanding the correlation between specific types of anemia and their associated blood cell characteristics is essential for nurses caring for pediatric patients. Recognizing the link between Vitamin B12 deficiency and macrocytosis aids in prompt identification and intervention, ultimately improving patient outcomes.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Von Willebrand disease. Von Willebrand disease is a common inherited bleeding disorder characterized by a deficiency or dysfunction of the von Willebrand factor, which plays a crucial role in platelet adhesion and aggregation. This deficiency leads to prolonged bleeding time despite having normal platelet counts. Option A) Hemophilia A is incorrect because it is a deficiency in factor VIII, a clotting factor, leading to prolonged clotting time but not affecting platelet counts. Option C) Leukemia is incorrect because it is a type of cancer affecting the bone marrow, leading to abnormal white blood cell production, but it does not directly impact platelet counts and bleeding time. Option D) Hypersplenism is incorrect as it involves the spleen's excessive removal of blood cells, including platelets, leading to a decrease in platelet count, but it does not cause prolonged bleeding time with normal platelet counts. For educational context, understanding the relationship between different clotting factors, platelet function, and bleeding disorders is crucial in pediatric nursing. Recognizing the specific characteristics of each disorder helps nurses provide accurate assessments, interventions, and education to support pediatric patients and their families effectively.

Correct Answer: D

Rationale: Rationale: The correct answer is D) Purely motor. Poliomyelitis is a viral infection that primarily affects the motor neurons in the spinal cord, leading to muscle weakness and paralysis. This paralysis is purely motor because it affects the muscles controlled by the damaged motor neurons, resulting in muscle atrophy and weakness without sensory deficits. Option A) Symmetrical paralysis is incorrect because while polio can cause symmetric weakness, it is not the defining characteristic. Other conditions like Guillain-Barre syndrome can also present with symmetrical paralysis. Option B) Complete recovery is incorrect because not all cases of polio result in complete recovery. Some individuals may have long-term complications or residual weakness. Option C) Associated with sensory loss is incorrect because polio primarily affects the motor neurons, leading to motor deficits. Sensory loss is not a typical feature of poliomyelitis. Educational Context: Understanding the characteristic signs of poliomyelitis paralysis is crucial for pediatric nurses as they care for children affected by this condition. By recognizing the motor nature of the paralysis in polio, nurses can provide appropriate care and support to these patients. This knowledge also helps in differentiating polio from other neuromuscular conditions with similar presentations, leading to accurate diagnosis and management.

Correct Answer: C

Rationale: In this case, the most probable diagnosis for the 1.5-month-old girl with icterus, edema, acholic stools, and exclusively breast-fed is neonatal cholestasis, which is the correct answer (C). Neonatal cholestasis refers to any condition that interrupts the flow of bile from the liver within the first 3 months of life. This condition leads to the accumulation of bile acids in the liver and bloodstream, resulting in jaundice, pale stools, and dark urine. Option A, Crigler-Najjar syndrome type 1, is less likely because this condition usually presents in the first few days of life with severe unconjugated hyperbilirubinemia and requires lifelong treatment with phototherapy or liver transplantation. Option B, Breast milk jaundice, is an incorrect choice as this condition typically presents with mild unconjugated hyperbilirubinemia in healthy, thriving infants and resolves spontaneously without any intervention. Option D, Crigler-Najjar syndrome type 2, is also less likely as it presents later in infancy or childhood with milder symptoms compared to type 1. Educationally, understanding the differentiation between neonatal cholestasis and other causes of jaundice in infants is crucial for pediatric nurses. Recognizing the signs and symptoms, as well as the appropriate diagnostic and management strategies for neonatal cholestasis, is essential for providing optimal care to these vulnerable patients. Early identification and intervention can prevent complications and improve outcomes for infants with neonatal cholestasis.

Correct Answer: C

Rationale: In the diagnosis of rheumatic fever, one major Jones criteria is Erythema marginatum. Erythema marginatum is a painless, non-pruritic rash with characteristic serpiginous borders. It is important to recognize this criteria as it helps in confirming the diagnosis of rheumatic fever. Arthralgia (option B) is a common symptom of rheumatic fever, but it is not a major Jones criteria for its diagnosis. Fever (option A) is also a common symptom, but not specific to rheumatic fever. Prolonged PR-interval (option D) is associated with rheumatic carditis, a complication of rheumatic fever, but it is not a major diagnostic criteria on its own. Educationally, understanding the major Jones criteria for rheumatic fever is crucial for healthcare providers, especially pediatric nurses, as they play a key role in early recognition and management of this condition in children. By knowing the specific criteria, nurses can advocate for timely treatment and help prevent complications associated with rheumatic fever.