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

Correct Answer: D

Rationale: The correct answer is D) Vitamin B12 deficiency. Macrocytosis is a condition characterized by larger than normal red blood cells. This occurs in Vitamin B12 deficiency anemia due to impaired DNA synthesis in red blood cell precursors, leading to larger and ineffective red blood cells. Option A) Sickle cell anemia is not associated with macrocytosis. Sickle cell anemia causes microcytosis, where red blood cells are smaller than normal due to the abnormal hemoglobin structure. Option B) Aplastic anemia is not associated with macrocytosis. Aplastic anemia is a condition where the bone marrow doesn't produce enough blood cells, leading to pancytopenia rather than macrocytosis. Option C) Congenital spherocytosis is not associated with macrocytosis. Congenital spherocytosis is a hemolytic anemia characterized by spherical-shaped red blood cells, not larger cells. Understanding the association between specific types of anemia and their corresponding red blood cell characteristics is crucial in pediatric nursing. Recognizing macrocytosis in Vitamin B12 deficiency anemia can guide appropriate diagnostic and treatment interventions to manage the condition effectively.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Von Willebrand disease. Von Willebrand disease is a bleeding disorder characterized by a deficiency or dysfunction of von Willebrand factor, which plays a crucial role in platelet adhesion and clot formation. Therefore, even though the platelet count may be normal, the prolonged bleeding time is a result of the impaired clotting mechanism due to the deficiency of von Willebrand factor. Option A) Hemophilia A is incorrect because hemophilia is a deficiency of specific clotting factors, usually factor VIII or IX, leading to prolonged bleeding time with a decreased platelet plug formation. Option C) Leukemia is incorrect as it is a cancer of the blood and bone marrow, which may present with thrombocytopenia (low platelet count) leading to bleeding tendencies, but not with a normal platelet count and prolonged bleeding time. Option D) Hypersplenism is incorrect because it is a condition where the spleen removes blood cells, including platelets, leading to thrombocytopenia and increased bleeding risk, not a normal platelet count with prolonged bleeding time. Educationally, understanding the relationship between platelet function, clotting factors, and specific bleeding disorders is crucial in pediatric nursing practice. Recognizing the signs and symptoms of various bleeding disorders and their underlying pathophysiology is essential for accurate diagnosis and appropriate management to provide optimal care for pediatric patients with bleeding disorders.

Correct Answer: D

Rationale: Rationale: The correct answer is D) Purely motor. Poliomyelitis is a viral infection that predominantly affects the motor neurons of the spinal cord, leading to muscle weakness or paralysis. This paralysis is typically asymmetric and primarily affects the lower limbs. The virus selectively attacks the motor neurons, resulting in weakness without significant sensory deficits. Option A) Symmetrical paralysis is incorrect because polio paralysis is usually asymmetric, affecting one side of the body more than the other. Option B) Complete recovery is incorrect as polio can lead to long-term disabilities and in some cases, permanent paralysis. Option C) Associated with sensory loss is incorrect as polio primarily affects motor function, sparing sensory pathways. Understanding the characteristic signs of polio paralysis is crucial in pediatric nursing as it helps in early identification, appropriate management, and prevention of complications. By recognizing the specific features of polio paralysis, healthcare providers can provide targeted care and support to affected children, improving their outcomes and quality of life.

Correct Answer: C

Rationale: The correct answer is C) Neonatal cholestasis. In this scenario, the infant presents with icterus, edema, and acholic stools, which are indicative of liver dysfunction and cholestasis. The mismatch in blood groups between the baby (A +ve) and the mother (O +ve) rules out hemolytic disease of the newborn, making neonatal cholestasis the most probable diagnosis. Option A) Crigler-Najjar syndrome type 1 and D) Crigler-Najjar syndrome type 2 are unlikely as they present with unconjugated hyperbilirubinemia without hepatomegaly or liver dysfunction, which are not prominent features in this case. Option B) Breast milk jaundice is characterized by mild unconjugated hyperbilirubinemia due to a component in breast milk. However, the presence of acholic stools and the severity of symptoms in this case make breast milk jaundice less likely. Educationally, understanding the differential diagnosis of neonatal jaundice is crucial for pediatric nurses to provide timely and appropriate care. Recognizing the signs and symptoms of neonatal cholestasis can lead to early intervention and prevent potential complications associated with liver dysfunction in infants.

Correct Answer: C

Rationale: The correct major Jones criteria for the diagnosis of rheumatic fever is C) Erythema marginatum. This characteristic rash is a specific indicator of rheumatic fever and is a key diagnostic feature. Erythema marginatum is a painless, non-pruritic rash that appears as pink rings with central clearing on the trunk and inner surfaces of the arms and legs. Option A) Fever is a common symptom in many illnesses and is not specific to rheumatic fever. Arthralgia (Option B) refers to joint pain and can be present in various conditions, not just rheumatic fever. Prolonged PR-interval (Option D) is an EKG finding associated with rheumatic carditis, a complication of rheumatic fever, but it is not a major Jones criteria for diagnosis. In an educational context, understanding the major and minor Jones criteria is crucial for healthcare providers, especially pediatric nurses, as rheumatic fever can have serious consequences if not promptly diagnosed and treated. By recognizing specific criteria like Erythema marginatum, nurses can aid in early detection and management of rheumatic fever in pediatric patients, ultimately improving outcomes and preventing potential complications.