Recurrent parotitis is the MOST common manifestation in children with primary Sjogren syndrome between 9-10 years of age.

Correct Answer: A

Rationale: In pediatric nursing, understanding the manifestations of different conditions is crucial for accurate diagnosis and effective care. In the case of primary Sjogren syndrome in children aged 9-10 years, recurrent parotitis is indeed the most common presentation. The correct answer is A) recurrent parotitis. Recurrent parotitis is a hallmark symptom of primary Sjogren syndrome in this age group. The parotid glands become inflamed multiple times, leading to recurrent episodes of swelling and pain. This manifestation distinguishes primary Sjogren syndrome from other conditions. Option B) sicca symptoms, which include dry eyes and mouth, are more typical of adult-onset Sjogren syndrome. Children with primary Sjogren syndrome often present with parotitis before developing sicca symptoms. Option C) polyarthritis is more commonly associated with juvenile idiopathic arthritis, another condition that can present with joint inflammation in children but is not a primary feature of Sjogren syndrome. Option D) vulvovaginitis is not a typical manifestation of Sjogren syndrome in children and is more commonly seen in conditions like allergic reactions or infections in the genital area. Educationally, this question highlights the importance of recognizing age-specific manifestations of autoimmune conditions in pediatric patients. Understanding these nuances is essential for pediatric nurses to provide timely and accurate care to children with complex medical conditions.

Correct Answer: A

Rationale: In pediatric nursing, identifying signs of physical abuse in children is crucial to ensure their safety and well-being. The MOST common clue of physical abuse in children being a history of inflicted trauma (Option A) is correct because often abusers will provide inconsistent or implausible explanations for a child's injuries. This history is a key indicator for healthcare providers to investigate further and protect the child from ongoing abuse. Option B, burn marks, while a possible sign of physical abuse, are not as common as a history of inflicted trauma. Burns can also result from accidents or other medical conditions, making them less specific to abuse. Option C, bruises, are also a common sign of physical abuse, but the most telling clue is usually the history provided rather than the presence of bruises alone. Bruises can also be caused by accidental trauma or medical conditions. Option D, intestinal injury, is not typically the most common clue of physical abuse in children. While internal injuries can occur in cases of severe abuse, they are less common than external signs like a history of inflicted trauma. Educationally, understanding the subtleties of identifying physical abuse in children is crucial for healthcare providers working with pediatric patients. By recognizing the most common clues, such as a history of inflicted trauma, nurses can advocate for the safety of vulnerable children and ensure appropriate interventions are implemented to protect them from harm.

Correct Answer: A

Rationale: In this scenario, the least common cause of the 2-year-old child's symptoms is asthma, making option A the correct answer. Asthma is a common condition in children characterized by recurrent wheezing, coughing, and shortness of breath, but in this case, the child's failure to thrive and recurrent pulmonary infections point towards other underlying issues. Option B, aspiration, is a common cause of pulmonary infections in children, especially in those with swallowing difficulties or gastroesophageal reflux. Option C, food allergy, can also lead to respiratory symptoms in children, such as wheezing, but typically presents with other symptoms like hives, gastrointestinal issues, or anaphylaxis. Option D, cystic fibrosis, is a genetic disorder that affects the respiratory and digestive systems, leading to thick mucus production and recurrent infections. It is a more likely cause of the child's symptoms given the presence of failure to thrive and recurrent pulmonary infections. Educationally, understanding the differential diagnosis of a child presenting with failure to thrive and recurrent respiratory symptoms is crucial for pediatric nurses. This knowledge helps in providing timely and appropriate care, including early detection and management of conditions like cystic fibrosis that can significantly impact a child's health and quality of life.

Correct Answer: D

Rationale: The correct answer is D) Hypothyroidism. In this scenario, the infant presents with signs and symptoms suggestive of congenital hypothyroidism. Hypothyroidism can lead to jaundice, poor weight gain, decreased tone, umbilical hernia, and a large anterior fontanelle. Option A) Crigler-Najjar syndrome is characterized by unconjugated hyperbilirubinemia, not associated with the symptoms described. Option B) Gilbert disease typically presents with mild unconjugated hyperbilirubinemia without the other physical findings mentioned. Option C) Biliary atresia presents with jaundice and hepatomegaly, but not the specific constellation of symptoms described. Educationally, understanding the clinical presentation of hypothyroidism in infants is crucial for pediatric nurses. Early detection and treatment of congenital hypothyroidism are essential to prevent long-term complications like developmental delays. Nurses play a key role in screening, monitoring, and educating families about the importance of thyroid function in infants.

Correct Answer: D

Rationale: In pediatric nursing, the early discharge of a normal term infant is a critical decision that requires careful consideration to ensure the health and well-being of the newborn. The correct answer, D) Two successful feedings, is the exception among the listed options. This is because successful feedings alone do not guarantee the overall health and stability of the infant. Option A) Jaundice evident on day - Jaundice in a newborn requires monitoring and, in some cases, treatment to prevent complications. Discharging a jaundiced infant early may lead to inadequate follow-up and management. Option B) Positive VDRL - A positive VDRL test indicates the presence of syphilis, a serious infection that can have detrimental effects on the infant's health. Early discharge without proper treatment and monitoring can lead to severe consequences. Option C) Bleeding after circumcision - Bleeding after circumcision is a potential complication that requires close observation and intervention. Discharging the infant before ensuring the bleeding is under control can result in further complications. Educationally, understanding the reasons to avoid early discharge of newborns is crucial for nursing students and healthcare providers. It emphasizes the importance of comprehensive assessment, monitoring, and follow-up care to promote the health and safety of newborns. This knowledge helps in making informed decisions and providing quality care to infants and their families.