One of the following drugs may cause pyloric stenosis if administered to a premature infant

Correct Answer: D

Rationale: In this scenario, the correct answer is D) dexamethasone. Dexamethasone, a corticosteroid, is known to potentially cause pyloric stenosis in premature infants due to its impact on muscle tone and motility in the digestive system. Pyloric stenosis is a condition where the muscle at the base of the stomach thickens, leading to a blockage in the opening to the small intestine. Now, let's address why the other options are incorrect: A) Intravenous vitamin E: Vitamin E supplementation is not associated with pyloric stenosis in premature infants. It is generally considered safe and essential for premature infants' health. B) Indomethacin: While indomethacin is a nonsteroidal anti-inflammatory drug commonly used to treat patent ductus arteriosus in premature infants, it is not linked to causing pyloric stenosis. C) Enteric gentamicin: Gentamicin, an antibiotic, is not known to cause pyloric stenosis in premature infants. Its route of administration and mechanism of action do not typically lead to this condition. Educational Context: Understanding the potential adverse effects of medications on premature infants is crucial for pediatric nurses. By knowing which drugs can lead to complications like pyloric stenosis, nurses can make informed decisions when administering medications to this vulnerable population. This knowledge ensures safe and effective care for premature infants in neonatal settings.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding the contributory factors for the development of broncho-pulmonary dysplasia (BPD) is crucial for providing effective care to infants. In this question, the correct answer is B) dehydration during the 1st days of life. Dehydration is not a known contributing factor for the development of BPD. A) Immaturity is a well-known risk factor for BPD as premature infants with underdeveloped lungs are more susceptible to this condition. C) Chorioamnionitis, an infection of the fetal membranes during pregnancy, can lead to inflammation and damage to the developing lungs, increasing the risk of BPD. D) Malnutrition can also contribute to the development of BPD as inadequate nutrition can impair lung development and function. Educational context: By understanding the specific factors that contribute to BPD, nurses can implement preventive measures and appropriate interventions to reduce the incidence and severity of this condition in neonatal patients. It is essential for pediatric nurses to have a comprehensive knowledge of neonatal conditions like BPD to provide optimal care and support to infants in their care.

Correct Answer: A

Rationale: In neonatal necrotizing enterocolitis (NEC), an absolute indication for surgery is a positive result of abdominal paracentesis. This is because a positive result indicates the presence of free air or fluid in the peritoneal cavity, which signifies bowel perforation and the urgent need for surgical intervention to prevent further complications like sepsis or peritonitis. Option B, failure of medical management, is not an absolute indication for surgery in NEC. While it may lead to consideration of surgery, other factors need to be taken into account before proceeding with surgical intervention. Option C, a single fixed bowel loop on radiographs, and option D, a palpable mass, are not specific or absolute indications for surgery in NEC. These findings may suggest the presence of bowel pathology but do not definitively indicate the need for surgical intervention. In an educational context, it is crucial for healthcare providers, especially pediatric nurses, to understand the critical indications for surgical intervention in neonatal NEC. This knowledge can help in prompt recognition of surgical emergencies and timely referral for appropriate management, ultimately improving patient outcomes and reducing morbidity and mortality associated with NEC.

Correct Answer: C

Rationale: The correct answer is C) Hemorrhagic disease of the newborn. The apt test, also known as the activated partial thromboplastin time test, is useful for diagnosing coagulation disorders by assessing the intrinsic pathway of the clotting cascade. In the context of pediatric nursing, this test is particularly important in newborns to detect conditions like hemorrhagic disease of the newborn, which is characterized by vitamin K deficiency leading to abnormal bleeding. Option A) Disseminated intravascular coagulopathy (DIC) is a condition where the body's clotting process is activated abnormally, leading to excessive clot formation and consumption of clotting factors. The apt test is not specific to diagnosing DIC, which typically requires a combination of tests looking at various clotting factors. Option B) Swallowed blood syndrome is not a recognized medical condition. There is no specific test associated with this term in clinical practice. Option D) Neonatal thrombocytopenic purpura involves a low platelet count in newborns, leading to a risk of bleeding. While the apt test may provide some information about the clotting process, it is not the primary test used for diagnosing thrombocytopenia. In pediatric nursing, understanding the indications and interpretation of coagulation tests like the apt test is crucial for providing safe and effective care to newborns and children with bleeding disorders. Recognizing the specific conditions for which these tests are useful helps nurses intervene promptly and appropriately to manage and treat these conditions, ultimately ensuring better outcomes for pediatric patients.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the agents that commonly cause nosocomial neonatal infections is crucial for providing safe and effective care to newborns. The correct answer, option D) Gonococci, is a significant pathogen that can cause infections in newborns, especially through vertical transmission during childbirth if the mother is infected. Option A) Group B streptococci is a common cause of neonatal infections, but it is typically acquired from the mother during childbirth rather than nosocomially. Coagulase-negative staphylococci (option B) are common skin flora and can cause infections, but they are not typically associated with nosocomial neonatal infections. Option C) Proteus is not a common agent in nosocomial neonatal infections. Educationally, understanding the specific pathogens that can cause infections in newborns helps nurses and healthcare providers in implementing appropriate infection control measures, early identification of infections, and prompt treatment to prevent complications in vulnerable neonates. It also highlights the importance of maternal screening and prophylaxis to prevent neonatal infections.