Sonya's small stature was probably due to:

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Failure to absorb nutrients because of the lack of pancreatic enzymes. Sonya's small stature is likely due to malabsorption of nutrients, specifically because of the lack of pancreatic enzymes needed for proper digestion and absorption of food. In conditions like cystic fibrosis, which commonly affects the pancreas, the lack of pancreatic enzymes can lead to poor nutrient absorption and ultimately result in stunted growth. Option A is incorrect because poor appetite and ingestion of less than normal quantities of food, while it can contribute to poor growth, typically would not result in as severe growth failure as seen in this case. Option C is incorrect because a deficiency in pituitary growth hormone would lead to a different pattern of growth failure, often with proportional short stature rather than the severe failure to thrive seen in pancreatic enzyme deficiency. Option D is incorrect because lack of motor activity leading to muscular and bony atrophy would not be the primary cause of Sonya's small stature in this context. Understanding the reasons behind growth failure in pediatric patients, especially in cases involving respiratory distress and malabsorption issues, is crucial for nurses caring for these patients. Recognizing the impact of pancreatic enzyme deficiency on growth can guide appropriate interventions and nutritional support to promote optimal growth and development in these children.

Correct Answer: C

Rationale: The correct answer is C) Tape test prior to defecating. This test involves placing a piece of clear tape near the child's anus in the morning before they defecate. The tape is then examined under a microscope for pinworm eggs, which are indicative of an infection. This method is non-invasive, simple, and cost-effective, making it the most common and preferred test for diagnosing pinworms in children. Option A, three stool specimens at intervals of 4 days, is not the most common test for pinworms. While stool samples can sometimes be used to detect pinworm eggs, the tape test is more specific and reliable for diagnosing pinworm infections. Option B, observation for the presence of worms after the child defecates, is not a recommended diagnostic method. Pinworms are typically small and difficult to see with the naked eye, making this method unreliable for diagnosis. Option D, a lower GI series, is not typically used to diagnose pinworm infections. This imaging study is more invasive and not necessary for the diagnosis of pinworms, which can be easily confirmed through non-invasive methods like the tape test. In an educational context, understanding the most appropriate and commonly used diagnostic tests for common childhood infections like pinworms is crucial for nurses working in pediatric healthcare settings. By knowing the most effective methods for diagnosis, nurses can ensure accurate and timely identification of infections, leading to appropriate treatment and improved outcomes for pediatric patients.

Correct Answer: D

Rationale: The correct answer is D) Measles (rubeola) because Koplik spots are a specific symptom associated with measles. Koplik spots are small white or bluish-white spots with a red halo that appear inside the mouth on the buccal mucosa opposite the molars. They are considered a pathognomonic sign of measles. Option A) Chickenpox (varicella) is incorrect because it does not present with Koplik spots. Chickenpox typically manifests as a vesicular rash that starts on the trunk and spreads to the limbs. Option B) Rubella is incorrect because Koplik spots are not associated with rubella. Rubella is characterized by a fine, pink-red rash that starts on the face and spreads downward. Option C) Exanthema subitum (roseola) does not present with Koplik spots. Roseola is distinguished by high fever followed by a rash. Understanding the presence of Koplik spots in measles is crucial for nurses caring for pediatric patients with respiratory distress. Recognizing this symptom can aid in early identification and isolation of measles cases to prevent its spread in healthcare settings and communities. This knowledge is essential for providing safe and effective care to pediatric patients with communicable diseases.

Correct Answer: B

Rationale: The correct answer is option B: Varicella-zoster immune globulin (VZIG) to prevent chickenpox. This option is the most appropriate recommendation because children undergoing chemotherapy are immunocompromised and at high risk for severe complications from chickenpox. VZIG provides passive immunity by giving antibodies to fight the varicella-zoster virus, reducing the severity of the infection in these vulnerable individuals. Option A (Acyclovir) is incorrect because it treats the symptoms but does not prevent the disease. Option C (Stopping chemotherapy) is also incorrect as it could jeopardize the cancer treatment and is not a guarantee that the immune system will recover quickly enough to prevent chickenpox. Option D (No precautions necessary) is the riskiest choice as it neglects the heightened vulnerability of immunocompromised children to infections like chickenpox. In an educational context, it is crucial for healthcare providers, including school nurses, to be aware of the specific needs of immunocompromised individuals, especially in environments like schools where infectious diseases can easily spread. Understanding the appropriate interventions to protect these vulnerable populations is essential in providing safe and effective care.

Correct Answer: B

Rationale: The correct answer is B) Cochlear implant. A cochlear implant is an implanted prosthesis specifically designed for individuals with sensorineural hearing loss, including children. It bypasses damaged parts of the inner ear and directly stimulates the auditory nerve, providing a sense of sound to individuals who are deaf or have severe hearing loss. Option A, a hearing aid, is an external device that amplifies sounds but may not be as effective for individuals with severe sensorineural hearing loss as a cochlear implant. Option C, an amplification device, is a broad term that can refer to various devices like hearing aids or cochlear implants, so it is not specific enough in this context. Option D, an auditory implant, is a general term and not as specific as a cochlear implant for addressing sensorineural hearing loss in children. In an educational context, understanding the differences between these devices is crucial for healthcare providers, especially nurses working with pediatric patients with hearing impairments. Knowing the specific interventions available for different types of hearing loss ensures appropriate care and support for these children and their families.