Regarding pubertal gynecomastia, which statement is TRUE?

Correct Answer: D

Rationale: In this question about pubertal gynecomastia, the correct answer is D) surgery may be indicated in severe or persistent cases. Gynecomastia in adolescent males is a common condition characterized by breast tissue enlargement due to hormonal changes during puberty. While gynecomastia often resolves on its own within 6 months to 2 years, persistent cases that cause significant psychological distress or physical discomfort may require surgical intervention. Option A) occurring in up to 20% of normal adolescent males is incorrect because the prevalence of pubertal gynecomastia is actually higher, affecting around 50-60% of males during puberty. Option B) onset typically is between 7 and 9 years is incorrect as puberty, when gynecomastia commonly occurs, usually starts around 9-14 years of age. Option C) usually regresses within 6 months is partially correct as most cases do resolve within this timeframe, but not always. In an educational context, it is crucial for pediatric clinical nurse specialists to understand the physiological and psychological implications of pubertal gynecomastia. By knowing when to reassure patients and families and when to consider interventions like surgery, nurses can support adolescents through this common yet potentially distressing experience. It is essential to provide holistic care that addresses both the physical and emotional well-being of patients experiencing gynecomastia during puberty.

Correct Answer: C

Rationale: The correct answer is C) alcohol. In the context of adolescents in the USA, alcohol is the most common factor that increases the likelihood of drowning. This is because alcohol impairs judgment, coordination, and reaction time, increasing the risk of accidents, including drowning incidents. Adolescents are more prone to engaging in risky behaviors, such as drinking alcohol, which can lead to dangerous situations like swimming while intoxicated. Option A) epilepsy is incorrect because epilepsy, a neurological condition characterized by seizures, does not directly increase the likelihood of drowning in adolescents unless a seizure occurs while swimming. Option B) long QT syndrome is a cardiac condition that can predispose individuals to sudden cardiac death but is not directly linked to an increased risk of drowning in adolescents. Option D) myocarditis, which is inflammation of the heart muscle, can lead to serious complications but is not a common factor contributing to the increased likelihood of drowning in adolescents in the USA. Educationally, it is crucial for pediatric clinical nurse specialists to understand the risk factors associated with drowning in adolescents to provide comprehensive care and education to both adolescents and their families. By recognizing the impact of alcohol and other risk factors on drowning incidents, healthcare providers can implement preventive strategies, such as education on water safety, responsible alcohol use, and close supervision during water activities, to reduce the occurrence of drowning in this population.

Correct Answer: B

Rationale: In the case of a preterm infant with patent ductus arteriosus (PDA), the primary treatment is indomethacin (Option B). This medication is a nonsteroidal anti-inflammatory drug that works by promoting closure of the ductus arteriosus, a crucial step in the transition from fetal to neonatal circulation. Antibiotics (Option A) are not the primary treatment for PDA, as this condition is not an infectious process. Corticosteroids (Option C) are also not indicated as the primary treatment for PDA in preterm infants. Surgery (Option D) is typically reserved for cases where medical management, such as indomethacin, has failed to close the ductus arteriosus. Educationally, it is important for pediatric clinical nurse specialists to understand the pathophysiology of PDA in preterm infants and be familiar with the appropriate pharmacological interventions. By knowing the correct treatment approach, nurses can contribute to improved outcomes for these vulnerable patients. It is crucial to stay updated on evidence-based practices in the care of preterm infants with cardiac conditions like PDA.

Correct Answer: C

Rationale: In this scenario, the most appropriate initial therapy for the 7-month-old patient with a high fever, tachycardia, tachypnea, hypotension, altered mental status, and a history of diarrhea is option C: normal saline (20-40 mL/kg). This choice is correct because the patient is presenting with signs of severe dehydration and shock, which require immediate fluid resuscitation to restore intravascular volume and improve perfusion to vital organs. Option A, cooling blankets, may help reduce fever, but the priority in this case is to address the underlying dehydration and shock. Option B, aspirin, is contraindicated in children with viral illnesses due to the risk of Reye syndrome. Option D, dantrolene, is used to treat malignant hyperthermia, which is not the primary concern in this case. From an educational standpoint, it is crucial for pediatric clinical nurse specialists to recognize the signs of dehydration and shock in pediatric patients and understand the appropriate interventions to stabilize the patient's condition. Prompt recognition and treatment of dehydration and shock can prevent further deterioration and improve patient outcomes. It is essential to prioritize interventions based on the patient's clinical presentation and immediate needs to provide safe and effective care.

Correct Answer: C

Rationale: The correct answer is C) bleeding would have been avoided by using ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) like naproxen, but it is less likely to cause bleeding issues compared to naproxen. Ibuprofen has less impact on platelet function and blood clotting, making it a safer choice for pain control in this scenario. Option A is incorrect because the dose of naproxen is within the recommended range for pain control in pediatrics. Option B is incorrect because while bleeding can be a side effect of NSAIDs like naproxen, it is not the main reason for the bleeding in this case. Option D is incorrect because both naproxen and aspirin are associated with bleeding risks, but aspirin is specifically linked to Reye syndrome, not naproxen. In an educational context, understanding the differences between NSAIDs and their potential side effects is crucial for healthcare providers, especially when managing pain in pediatric patients. It is important to consider individual patient factors, such as bleeding risks, when selecting the most appropriate medication for pain control after a surgical procedure.