Pneumatosis intestinalis is pathognomonic for

Correct Answer: B

Rationale: Pneumatosis intestinalis is pathognomonic for necrotizing enterocolitis (NEC) because it is a radiographic finding characterized by the presence of gas within the wall of the intestine. This finding is highly specific to NEC, a serious condition primarily affecting premature infants in the neonatal period. Option A, Hirschsprung's disease, is a congenital disorder characterized by the absence of ganglion cells in the colon, leading to functional obstruction. Pneumatosis intestinalis is not a typical finding in Hirschsprung's disease. Option C, pseudomembranous enterocolitis, is associated with Clostridium difficile infection and is characterized by the formation of pseudomembranes in the colon. Pneumatosis intestinalis is not a typical feature of this condition. Option D, neonatal ulcerative colitis, is a rare inflammatory bowel disease that can occur in neonates. Pneumatosis intestinalis is not pathognomonic for neonatal ulcerative colitis. Understanding the radiographic findings specific to each condition is crucial in pediatric nursing practice to ensure accurate diagnosis and timely intervention, especially in critically ill neonates where NEC can lead to serious complications if not promptly recognized and managed.

Correct Answer: A

Rationale: In this scenario, the most likely diagnosis for the 5-year-old boy is acute posttraumatic stress disorder (PTSD) (Option A). Acute PTSD occurs when symptoms develop within the first month after exposure to a traumatic event, which in this case is the car accident. The child is displaying classic signs of PTSD, such as anger, sadness, exaggerated startle response, and social withdrawal. Option B, chronic PTSD, is incorrect because the symptoms have been present for only a few weeks, which is not enough time to diagnose chronic PTSD. Option C, delayed onset PTSD, is also incorrect because symptoms of delayed onset PTSD typically appear six months or more after the traumatic event, whereas in this case, symptoms developed immediately after the car accident. Option D, acute stress disorder, is incorrect because the timeframe for this diagnosis is shorter, usually lasting between 3 days to 1 month after the traumatic event. The key to choosing the correct answer lies in understanding the timeline of symptom onset in relation to the traumatic event. Educationally, this case highlights the importance of recognizing and understanding the different types of trauma-related disorders in pediatric patients. It emphasizes the need for early identification and intervention to support children who have experienced traumatic events and are exhibiting symptoms of PTSD. Recognizing these signs early on can lead to appropriate treatment and support for the child's mental health and well-being.

Correct Answer: A

Rationale: In treating children with OCD, the best initial treatment is fluoxetine (Option A) due to its efficacy and safety profile in this population. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is FDA-approved for pediatric OCD and has been extensively studied in this population. It is generally well-tolerated and has shown effectiveness in reducing OCD symptoms in children. Clomipramine (Option B) is a tricyclic antidepressant that is also used for OCD, but it is less preferred in children due to its side effect profile and potential for toxicity. Risperidone (Option C) is an atypical antipsychotic and is not a first-line treatment for OCD in children. Anterior capsulotomy (Option D) is a surgical procedure typically reserved for severe, treatment-resistant cases of OCD and is not an appropriate initial treatment for children. From an educational standpoint, understanding the rationale behind selecting fluoxetine as the best initial treatment for pediatric OCD is crucial for healthcare providers working with children and adolescents with mental health conditions. It underscores the importance of evidence-based practice and tailoring treatment to the specific needs of pediatric patients to optimize outcomes while minimizing risks.

Correct Answer: D

Rationale: The correct answer is D) autism. Autism spectrum disorder (ASD) is characterized by stereotypic body movements, impaired communication skills, including verbal and nonverbal, and deficits in social interaction, such as absent empathy and difficulty forming friendships. Children with autism often struggle in social settings like daycare due to challenges in understanding social cues and forming relationships. Option A) Attention deficit hyperactivity disorder (ADHD) is primarily characterized by symptoms of inattention, hyperactivity, and impulsivity. While there may be some overlap in behaviors with autism, the absence of social communication deficits and stereotypic movements differentiate ADHD from autism. Option B) Dysthymic syndrome refers to a chronic type of depression characterized by a persistently low mood. This condition is not associated with the specific behavioral and social communication deficits seen in autism. Option C) Deaf-mutism is an outdated term and is not a recognized diagnosis. It refers to a combination of deafness and an inability to speak, which does not encompass the range of symptoms seen in autism. Educationally, understanding the key characteristics of autism is crucial for healthcare providers, especially those working in pediatric nursing. Recognizing the signs and symptoms early can lead to timely interventions and support for children with autism to improve their quality of life and developmental outcomes. Identifying the differences between autism and other conditions helps in making accurate diagnoses and providing appropriate care and resources for children and their families.

Correct Answer: C

Rationale: In pediatric nursing, understanding child behavior is crucial for providing effective care. When a 7-year-old child fails to cooperate with care in the hospital, one should suspect negativism. Negativism is a common behavior in young children where they resist or refuse to do what is asked of them. This can manifest as noncompliance with medical procedures or staff directives. Choosing option C as the correct answer is supported by the developmental stage of a 7-year-old child. At this age, children may exhibit negativism as they assert their independence and test boundaries. By recognizing this behavior as negativism, healthcare providers can approach the child with empathy and understanding, adapting strategies to encourage cooperation. Option A, immaturity, is not the best choice because failure to cooperate is more likely related to behavioral aspects rather than solely immaturity. Embarrassment (option B) is less likely in this context as it doesn't explain the consistent noncooperation. Fearfulness (option D) might be a factor, but negativism is a more common behavior in this age group. Educationally, understanding the psychological aspects of pediatric patients is essential for nurses to provide holistic care. By being aware of developmental behaviors like negativism, nurses can tailor their approach to build trust and rapport with pediatric patients, leading to better cooperation and positive health outcomes.