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 this question, the correct answer is A) independent occurrence of periungual tissue necrosis. This feature is most likely consistent with rheumatic disease (RD) rather than Raynaud phenomenon (RP) because periungual tissue necrosis is a more specific symptom associated with certain rheumatic diseases like systemic sclerosis, rather than RP alone. Option B) asymmetric involvement is a common feature of RP and does not specifically point towards RD. Option C) associated telangiectasia is more commonly associated with RP rather than RD. Option D) paresthesia and gangrene are symptoms that can occur in severe cases of RP but are not specific to RD. Educationally, this question highlights the importance of recognizing specific clinical features to differentiate between RP and RD in pediatric patients. Understanding these distinctions is crucial for accurate diagnosis and appropriate treatment interventions in pediatric nursing practice.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the psychosocial impact of war on children is crucial for providing holistic care. In this question, the correct answer is D) acute stress reaction. This is because acute stress reactions are a common and expected response to traumatic events such as war in children. It is a normal reaction to an abnormal situation and can manifest in various ways including anxiety, fear, and behavioral changes. Option A) loss of family members is a psychosocial impact of war on children as it can lead to grief, trauma, and a sense of abandonment. Option B) separation from community is also a valid psychosocial impact as it can result in feelings of isolation and loss of support systems. Option C) lack of education is another significant impact as war often disrupts schools and educational opportunities for children, impacting their future prospects and well-being. In an educational context, it is important for pediatric nurses to be aware of the various psychosocial impacts of war on children to provide effective care and support. By recognizing these effects, nurses can implement appropriate interventions to address the unique needs of children who have experienced war-related trauma. This knowledge helps in promoting resilience, facilitating healing, and promoting overall well-being in pediatric patients affected by war.

Correct Answer: D

Rationale: In pediatric nursing, the assessment and management of failure to thrive is crucial. When evaluating a child with failure to thrive, it is important to consider various underlying factors such as chromosomal abnormalities, intrauterine infections, and metabolic disorders. In this scenario, the correct answer is D) renal symptoms. Renal symptoms are not typically suggestive of metabolic problems in the context of failure to thrive. Metabolic disorders often present with insidious history, recurrent vomiting, and neurologic symptoms. Therefore, ruling out renal symptoms can help to narrow down the differential diagnosis in these cases. Insidious history, recurrent vomiting, and neurologic symptoms are common features of metabolic disorders in children. An insidious history refers to a gradual onset of symptoms, which is characteristic of metabolic conditions. Recurrent vomiting can be a sign of metabolic dysfunction affecting the gastrointestinal system. Neurologic symptoms such as seizures, developmental delay, and altered mental status are often seen in metabolic disorders due to their impact on the nervous system. Educationally, understanding the clinical presentation of different underlying factors in failure to thrive is essential for pediatric nurses to provide comprehensive care. By differentiating between symptoms suggestive of metabolic disorders and other conditions, nurses can assist in the early identification and appropriate management of children with failure to thrive.

Correct Answer: C

Rationale: In this case, 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 is essential for blood clotting. This condition is common in newborns who did not receive vitamin K prophylaxis at birth. Option A) Pyridoxine deficiency is incorrect because it is related to a deficiency in vitamin B6, which does not typically present with bleeding as a prominent symptom. Option B) Severe scurvy is incorrect as scurvy is caused by vitamin C deficiency and is not associated with bleeding disorders like hemorrhagic disease. Option D) Child abuse is unrelated to the symptoms described in the question and would not be a likely diagnosis based on the clinical presentation. In an educational context, understanding the differential diagnosis of bleeding in a newborn is crucial for pediatric nurses. Recognizing the signs and symptoms of hemorrhagic disease of the newborn is essential for prompt diagnosis and treatment to prevent serious complications such as intracranial hemorrhage. It also highlights the importance of vitamin K administration to newborns to prevent this condition.

Correct Answer: B

Rationale: In pediatric nursing, understanding the factors contributing to low-birthweight births is crucial for providing quality care to newborns. In this case, the correct answer is B) Prematurity. Prematurity is the leading cause of low-birthweight births in America, defined as babies born weighing less than 5.5 pounds. Preterm infants are at higher risk for a host of complications due to their underdeveloped organs and systems. Option A) Intrauterine growth retardation, while a significant factor in low birth weight, is not the predominant cause in America. It refers to babies who are small for gestational age due to factors affecting their growth in the womb. Option C) Multiple gestations can lead to low birth weight due to the shared resources among fetuses, but it is not the primary cause in America. Option D) Uterine bleeding, such as placental abruption, can be a risk factor for low birth weight in some cases, but it is not the predominant cause. Educationally, understanding the primary causes of low-birthweight births helps healthcare providers identify at-risk pregnancies early, implement appropriate interventions, and provide specialized care to promote optimal outcomes for both mother and baby. By grasping these concepts, nurses can better advocate for comprehensive prenatal care and support to reduce the incidence of prematurity and its associated complications.