Polycythaemia:

Correct Answer: B

Rationale: In the context of pediatric nursing pharmacology, understanding polycythemia in newborns is crucial for providing safe and effective care. The correct answer, B) Is significant if hematocrit > 65% on a capillary sample, is based on the understanding that polycythemia is defined by an elevated hematocrit level. A hematocrit level above 65% indicates a significant increase in red blood cells, which can lead to complications such as hyperviscosity and thrombosis in newborns. Option A) Is a common cause of jaundice in the newborn is incorrect because polycythemia itself does not directly cause jaundice. Jaundice in newborns is usually due to elevated bilirubin levels, often related to factors such as hemolysis or liver immaturity. Option C) May cause apneas is incorrect as polycythemia typically presents with symptoms such as ruddy skin color, hypoglycemia, and respiratory distress rather than apneas. The respiratory distress is usually due to increased blood viscosity affecting oxygen delivery. Option D) Exchange transfusion is the treatment of choice in symptomatic cases is incorrect because while exchange transfusion may be considered in severe cases of polycythemia with complications, it is not always the first-line treatment. Management of polycythemia often involves measures such as partial exchange transfusion, hydration, and monitoring for signs of complications. Educationally, understanding the implications of polycythemia in newborns is essential for nurses caring for this patient population. Recognizing the signs and symptoms of polycythemia, understanding appropriate diagnostic criteria like hematocrit levels, and knowing the management options are all critical aspects of providing competent care to newborns with this condition.

Correct Answer: C

Rationale: The correct answer is C) 5-year-old with difficulty in reading sentences from a book. This child is abnormal because at 5 years old, they should be able to read and understand simple sentences. Reading sentences from a book is an age-appropriate developmental milestone for a 5-year-old, so difficulty in doing so raises concerns about their language and cognitive development. Option A) 18-month-old who can put three blocks on top of each other and has a 2-word vocabulary is normal for that age. By 18 months, children typically have a small vocabulary and are beginning to stack blocks. Option B) A 3-month-old who has good head control and is reaching for objects is also normal. At 3 months, infants start to gain head control and show interest in reaching for objects as part of their motor development. Option D) A bottom-shuffler who is not walking at 16 months is not necessarily abnormal. Children develop at different rates, and some may start walking later than others without it being a cause for concern. Educationally, understanding developmental milestones is crucial for healthcare providers working with pediatric patients. Recognizing abnormal development can lead to early intervention and support for children who may need additional assistance in achieving their milestones. It is essential for nurses to be able to identify deviations from the norm to provide appropriate care and support for pediatric patients and their families.

Correct Answer: A

Rationale: In pediatric nursing pharmacology, understanding how different drugs impact hepatic enzymes is crucial for safe and effective medication administration. In this scenario, the correct answer is A) Rifampicin. Rifampicin is known to induce hepatic enzymes, particularly cytochrome P450 enzymes, which can increase the metabolism of other drugs and lead to decreased drug concentrations in the body. Option B) Phenobarbitone is also a drug that induces hepatic enzymes, specifically cytochrome P450 enzymes. Phenobarbitone is commonly used in pediatric patients for seizure control. Option C) Cimetidine is incorrect because it is actually a cytochrome P450 enzyme inhibitor, which can lead to increased drug concentrations when co-administered with other drugs metabolized by the same enzymes. Option D) Erythromycin does not induce hepatic enzymes. Instead, it is known to inhibit certain cytochrome P450 enzymes, leading to potential drug interactions when used concomitantly with other medications metabolized by the same enzymes. Understanding which drugs induce or inhibit hepatic enzymes is vital for pediatric nurses to prevent adverse drug interactions and ensure optimal therapeutic outcomes for their young patients. This knowledge helps in making informed decisions regarding medication selection, dosing, and monitoring in pediatric cardiovascular care.

Correct Answer: A

Rationale: In the context of pediatric nursing and pharmacology, understanding the causes of a dilated renal pelvis in a fetal scan is crucial for identifying potential issues in prenatal development. In this case, the correct answer is A) Normal variant. The dilation of the renal pelvis in a fetal scan can often be a normal variant and not indicative of any pathology. This physiological dilatation usually resolves on its own as the fetus develops, making it a common finding in routine prenatal scans. Understanding this normal variant helps prevent unnecessary parental anxiety and medical interventions. Option B) Vesico-ureteric reflux and Option C) Pelvi-ureteric junction obstruction are both pathological conditions that can cause a dilated renal pelvis in a fetal scan. Vesico-ureteric reflux is a condition where urine flows backward from the bladder to the ureters and kidneys, leading to renal pelvis dilation. Pelvi-ureteric junction obstruction is a blockage at the connection point between the renal pelvis and the ureter, causing dilation. Option D) Multicystic kidney is a congenital condition characterized by the presence of multiple cysts in the kidney, which can lead to enlargement of the affected kidney but not necessarily cause dilation of the renal pelvis in a fetal scan. Educationally, this question highlights the importance of differentiating between normal variants and pathological conditions in fetal scans, emphasizing the need for nurses to have a strong foundation in pediatric pharmacology to provide accurate patient care and education to families.

Correct Answer: C

Rationale: In this question, the correct answer is C) Epidermolysis bullosa. Epidermolysis bullosa is a genetic condition characterized by fragile skin that blisters and forms bullae with minimal trauma. This condition can present in newborn infants as a bullous eruption due to the fragility of their skin. Option A) Syphilis typically presents with other symptoms such as rash, hepatosplenomegaly, and jaundice in newborn infants, not just bullous eruptions. Option B) Mast cell disease is a condition involving the proliferation of mast cells in tissues, leading to symptoms like skin flushing, itching, and hives, but not specifically bullous eruptions. Option D) Phenylketonuria is a metabolic disorder that can lead to intellectual disabilities if not managed properly, but it does not typically manifest as bullous eruptions in newborns. Educationally, understanding the differentiating characteristics of various conditions that can present with skin manifestations in newborns is crucial for pediatric nurses. Recognizing the specific signs and symptoms of conditions like epidermolysis bullosa can aid in prompt diagnosis and appropriate management to improve patient outcomes.