Regarding school refusal, which statement is FALSE?

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding school refusal is crucial for providing comprehensive care to children. The correct answer to the question, "Regarding school refusal, which statement is FALSE?" is option D) older children usually suffer from obsessive disorders. This statement is false because older children typically do not usually suffer from obsessive disorders in the context of school refusal. While obsessive-compulsive disorder (OCD) can manifest in children of any age, it is not a defining characteristic or a common factor specifically associated with school refusal in older children. Option A) it is a complex disorder is true because school refusal is indeed a complex issue influenced by various factors such as anxiety, family dynamics, academic stress, and social challenges. Option B) selective mutism is overlapping is true as selective mutism, a condition where a child is unable to speak in certain social situations, can coexist with school refusal due to the anxiety and fear associated with school attendance. Option C) younger children usually have separation anxiety disorder is true as younger children often experience separation anxiety when away from their primary caregivers, which can contribute to school refusal behavior. In an educational context, this question helps pediatric nursing students deepen their understanding of the complexities of school refusal in children. By recognizing the false statement and understanding the nuances of school refusal across different age groups, students can better assess, intervene, and support children experiencing school refusal in clinical practice.

Correct Answer: D

Rationale: In this question, the correct answer is D) acute phobic hallucination. Childhood psychosis is a severe mental disorder characterized by a disconnection from reality. Hallucinations are sensory perceptions that appear real but are created by the mind, and in childhood psychosis, hallucinations can be auditory, visual, or tactile. However, acute phobic hallucinations specifically relate to intense fears or phobias, not psychosis. Option A) delusions are false beliefs, often irrational, that are maintained despite evidence to the contrary. Delusions are a common symptom of psychosis. Option B) loss of reality testing refers to the inability to distinguish between what is real and what is not real, a hallmark feature of psychosis. Option C) disorganized speech is another common symptom of psychosis where a person's speech may be incomprehensible or incoherent due to disorganized thinking processes. In an educational context, understanding the differences between various symptoms of childhood psychosis is crucial for pediatric nurses to provide appropriate care and support to patients and their families. Recognizing these symptoms early can lead to timely interventions and improved outcomes for children experiencing psychosis.

Correct Answer: B

Rationale: In pediatric nursing, understanding maternal serum α-fetoprotein (MSAFP) levels is crucial for early detection of certain fetal abnormalities. A low MSAFP level is associated with trisomy 21, also known as Down syndrome. This is because fetuses with trisomy 21 often have lower levels of MSAFP due to impaired placental functioning. Option A, open neural tube defects, are associated with high MSAFP levels, not low. Options C and D, gastroschisis and omphalocele, are related to defects in the abdominal wall and are not typically linked to MSAFP levels. Educationally, knowing the correlation between MSAFP levels and specific fetal abnormalities helps nurses provide anticipatory guidance to families, facilitating early interventions and support. This knowledge also underscores the importance of prenatal screening and the role of healthcare providers in guiding families through potential diagnoses.

Correct Answer: D

Rationale: The correct answer is D) a poor prognosis. After severe birth asphyxia, infants may exhibit motor automatisms as a sign of central nervous system damage. These automatisms are often associated with a poor prognosis due to the extent of brain injury sustained during the asphyxial event. Motor automatisms in this context can manifest as abnormal, involuntary movements or posturing that indicate significant neurological impairment. Option A) absence of oral-buccal-lingual movements is incorrect because motor automatisms after severe birth asphyxia typically involve abnormal movements rather than a lack of movement. Option B) time-synchronized electroencephalographic discharges is incorrect as it describes a specific EEG finding and not motor automatisms. Option C) significant cortical epileptic activity is incorrect because while seizures can occur after birth asphyxia, it is not indicative of motor automatisms specifically. In an educational context, understanding the implications of motor automatisms following severe birth asphyxia is crucial for pediatric nurses. Recognizing these signs can prompt early intervention and appropriate care planning for infants with neurological sequelae. It underscores the importance of timely assessments, monitoring, and collaboration with the healthcare team to optimize outcomes for these vulnerable patients.

Correct Answer: D

Rationale: In the case of Respiratory Distress Syndrome (RDS) in neonates, the basic defect requiring treatment is inadequate pulmonary exchange of oxygen and carbon dioxide, which is correctly identified in option D. RDS, also known as Hyaline Membrane Disease, occurs due to a lack of surfactant in the immature lungs of preterm infants, leading to difficulty in oxygen uptake and carbon dioxide removal. Option A, metabolic acidosis, is incorrect because though it can be a consequence of inadequate oxygen exchange, it is not the primary defect in RDS. Option B, circulatory insufficiency, is also incorrect as the main issue in RDS lies within the lungs, affecting gas exchange, not the overall circulation. Option C, hypothermia, is unrelated to the pathophysiology of RDS. In an educational context, understanding the pathophysiology of RDS is crucial for pediatric nurses as they care for neonates at risk. Recognizing the primary defect guides appropriate interventions such as oxygen therapy, mechanical ventilation, and surfactant replacement therapy, which are vital in managing RDS and improving outcomes for these vulnerable patients.