Permanent contraindication to breastfeeding is recommended in

Correct Answer: B

Rationale: In this scenario, the correct answer is B) galactosemia of the infant. Galactosemia is a rare genetic metabolic disorder where infants lack the enzyme needed to metabolize galactose properly. Breast milk contains galactose, which can be harmful to infants with galactosemia, leading to severe complications or even death. Therefore, breastfeeding is contraindicated in infants with galactosemia. Option A) active tuberculosis of the mother is not a permanent contraindication to breastfeeding. Proper precautions can be taken to ensure safe breastfeeding practices. Option C) Varicella of the mother is not a permanent contraindication to breastfeeding. In fact, breastfeeding can provide passive immunity to the infant against varicella. Option D) H1N1 influenza of the mother is not a permanent contraindication to breastfeeding. With proper hygiene measures and possibly wearing a mask, breastfeeding can continue safely. Educationally, understanding contraindications to breastfeeding is crucial for nurses and healthcare professionals caring for infants. It is important to be aware of conditions that may impact the safety of breastfeeding and to provide appropriate guidance and support to mothers in making informed decisions regarding infant feeding.

Correct Answer: D

Rationale: In the context of nutritional rehabilitation for a malnourished child, the correct answer is D) iron supplements are recommended. Iron supplements are not typically required at the beginning of nutritional rehabilitation but may be needed later if laboratory tests show iron deficiency. Option A is incorrect because a gradual increase in caloric intake, typically starting at 10% to 20% per day, is a safe approach to prevent refeeding syndrome. Option B is incorrect because caloric intake should not be increased to the point of initiating catch-up growth too quickly, as this can lead to complications like refeeding syndrome. Option C is incorrect because while protein needs may increase as anabolism begins, this does not happen right at the start of nutritional rehabilitation. It usually occurs later in the process as the child's nutritional status improves. Educationally, understanding the nuances of nutritional rehabilitation in malnourished children is crucial for nurses and healthcare providers working in pediatric settings. It is essential to monitor and adjust nutritional interventions carefully to prevent complications and promote optimal growth and development in these vulnerable patients.

Correct Answer: C

Rationale: In this NCLEX Pediatric Gastrointestinal Practice Question, the correct answer is C) niacin (B3). The mnemonic "4 D's" (dermatitis, dementia, diarrhea, and death) is specifically associated with niacin deficiency. Niacin (B3) deficiency leads to a range of symptoms including dermatitis, dementia, diarrhea, and if severe and left untreated, it can lead to death. Niacin is essential for the proper functioning of various enzymes involved in energy metabolism, DNA repair, and cell signaling. Looking at the other options: A) Thiamine (B1) deficiency is known to cause Beriberi, not the 4 D's. B) Riboflavin (B2) deficiency leads to symptoms like sore throat, redness and swelling of the lining of the mouth and throat, but not the 4 D's. D) Pyridoxine (B6) deficiency can cause dermatitis, glossitis, and peripheral neuropathy, but not all 4 D's. Educationally, understanding these mnemonics and associations helps in recalling key information during exams and in clinical practice. By linking niacin deficiency to the 4 D's, students can quickly identify and address potential issues related to this specific vitamin deficiency. This rationale reinforces the importance of memorizing key associations in pediatric gastrointestinal health.

Correct Answer: C

Rationale: The best management for the 6-week-old preterm infant with anemia, elevated reticulocyte count, and thrombocytosis is to give folic acid (Option C). This infant likely has hemolytic anemia due to an underlying cause such as a deficiency in folic acid. Folic acid supplementation helps in the production of red blood cells and can aid in the treatment of anemia in this case. Option A is incorrect because anemia, elevated reticulocyte count, and thrombocytosis indicate a more serious condition that requires intervention rather than just reassurance. Option B, giving packed cell blood, is not the first-line treatment for this type of anemia. Option D, repeating the CBC in 2 weeks, delays necessary treatment for the infant's condition. Educationally, understanding the underlying pathophysiology of anemia in infants is crucial for nurses and healthcare providers caring for pediatric patients. Recognizing the signs and symptoms of different types of anemia and knowing the appropriate interventions, such as folic acid supplementation in this case, is essential for providing safe and effective care to pediatric patients with hematologic disorders.

Correct Answer: B

Rationale: The correct answer is B) vitamin C deficiency. Osteoporosis in childhood is typically associated with factors such as inadequate calcium and vitamin D intake, sedentary lifestyle, certain medical conditions, and medications like corticosteroids. Protein-calorie malnutrition (option A) can lead to osteoporosis due to lack of essential nutrients for bone growth and maintenance. Zinc deficiency (option C) can also contribute to bone health issues as zinc is important for bone formation and mineralization. Steroid therapy (option D) can cause bone loss by interfering with calcium absorption and bone formation. In an educational context, it is crucial for healthcare professionals, especially those working with pediatric patients, to understand the risk factors for pediatric osteoporosis to provide appropriate prevention and management strategies. By knowing the factors that contribute to bone health issues in children, healthcare providers can offer holistic care to promote optimal skeletal development and overall well-being.