Raynaud phenomenon (RP) associated with rheumatic disease (RD) is usually consistent with RD rather than RP. The feature that is MOST likely consistent with RD rather than RP is

Correct Answer: A

Rationale: In the context of pediatric nursing and rheumatic diseases, understanding the distinguishing features of Raynaud phenomenon (RP) and rheumatic disease (RD) is crucial for accurate assessment and diagnosis. The correct answer, option A) independent occurrence of periungual tissue necrosis, is most likely consistent with RD rather than RP. This is because periungual tissue necrosis is a more specific and characteristic feature of certain rheumatic diseases, such as systemic sclerosis, rather than RP. Option B) asymmetric involvement is a common feature of RP, where affected extremities may exhibit uneven symptoms, making it less indicative of RD. Option C) associated telangiectasia is also more commonly associated with RP rather than RD, as it refers to the dilatation of small blood vessels near the surface of the skin, a hallmark of RP. Option D) paresthesia and gangrene are more severe manifestations that can occur in either RP or RD but are not as specific to RD as periungual tissue necrosis. Educationally, understanding these nuances is important for nurses caring for pediatric patients with rheumatic diseases. By recognizing the distinguishing features of RP and RD, nurses can provide more targeted assessments, interventions, and patient education. This knowledge can also aid in timely referrals to specialists for further evaluation and management of these conditions.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the psychosocial impact of war on children is crucial for providing comprehensive care. The correct answer, option D, "acute stress reaction," is not a factor that shows the psychosocial impact of war on children. Acute stress reactions are immediate responses to a traumatic event and do not necessarily encompass the long-term effects of war on children's mental health. Option A, "loss of family members," is a significant psychosocial impact of war on children as it can lead to feelings of grief, abandonment, and emotional distress. Children rely heavily on their families for support and stability, so losing family members can have profound effects on their well-being. Option B, "separation from community," is another important factor as war often displaces families, forcing children to leave their familiar environments, friends, and support systems. This can result in feelings of isolation, loneliness, and a lack of belonging. Option C, "lack of education," is also a relevant factor as war disrupts educational systems, leading to limited access to schooling, resources, and opportunities for children. This can impact their cognitive development, social interactions, and future prospects. Educationally, it is essential for pediatric nurses to be aware of these psychosocial impacts to provide holistic care for children affected by war. By understanding these factors, nurses can implement appropriate interventions, offer support services, and advocate for policies that promote the well-being of these vulnerable populations.

Correct Answer: D

Rationale: In pediatric nursing, the identification and differentiation of various causes of failure to thrive are crucial for providing appropriate care. Metabolic disorders are one of the key areas to consider in such cases. Option D, "renal symptoms," is the correct answer as it is not typically suggestive of metabolic problems. Renal symptoms would point more towards issues related to the kidneys rather than metabolic disorders. Option A, "insidious history," is indicative of a metabolic problem as these disorders often present with a gradual onset and progression, which aligns with an insidious history. Option B, "recurrent vomiting," is suggestive of metabolic issues as it can be a sign of metabolic acidosis or other metabolic disturbances. Option C, "neurologic symptoms," are also often seen in metabolic disorders due to the impact of metabolic derangements on the nervous system. Educationally, understanding these distinctions is vital for nurses caring for pediatric patients with failure to thrive. Recognizing the specific signs and symptoms associated with metabolic disorders can lead to timely interventions and improved outcomes for these vulnerable patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Hemorrhagic disease of the newborn. Hemorrhagic disease of the newborn is a condition characterized by bleeding in the first few days of life due to vitamin K deficiency, which can lead to serious complications if not treated promptly. This condition is common in infants who did not receive vitamin K prophylaxis at birth. Option A) Pyridoxine deficiency is incorrect because it is related to vitamin B6 deficiency, which does not typically present with bleeding in newborns. Option B) Severe scurvy is incorrect as scurvy is caused by vitamin C deficiency and is rare in newborns. Option D) Child abuse is incorrect in this context as the symptoms described are indicative of a medical condition (hemorrhagic disease of the newborn) rather than physical trauma. Educationally, understanding the importance of vitamin K administration to newborns is crucial for healthcare providers working in pediatric settings. This question highlights the significance of early recognition and management of hemorrhagic disease of the newborn to prevent serious complications such as intracranial hemorrhage. Healthcare professionals need to be vigilant in ensuring that newborns receive appropriate vitamin K supplementation to prevent this potentially life-threatening condition.

Correct Answer: B

Rationale: The correct answer is B) Prematurity. Prematurity, defined as a birth that occurs before 37 weeks of gestation, is the leading cause of low-birthweight births in America. Infants born prematurely are at a higher risk of health complications due to their underdeveloped organ systems. These babies may experience issues with breathing, feeding, and maintaining their body temperature. Option A) Intrauterine growth retardation (IUGR) is a condition where a baby doesn't grow well in the womb, leading to low birth weight, but it is not the predominant cause of low-birthweight births in America. Option C) Multiple gestations, or twins/triplets, can result in low-birthweight babies due to the shared resources in the womb. However, prematurity is still the primary cause of low birth weight in America. Option D) Uterine bleeding, while a concern during pregnancy, is not directly linked to low-birthweight births as prematurity is. In an educational context, understanding the causes of low birth weight is crucial for pediatric nurses to provide appropriate care for these vulnerable infants. By recognizing prematurity as the primary cause, nurses can focus on interventions to support these babies and their families effectively. Educating expectant mothers on the importance of prenatal care and healthy lifestyle choices to prevent premature births is also a key role for pediatric nurses.