Sonya Santos weighed 7 lbs at the time of her birth. 2 months later, her mother noted that the stools were frequently foul-smelling and frothy. During the next few months, Sonya failed to gain weight so her mother took her to the pediatric clinic at the age of 9 months. The examining physician found Sonya to be poorly developed, underweight and suffering from bronchitis with frequent non-productive cough. Chest x-ray, blood tests, stool analysis and sweat were done. Sonya's family history revealed that she has a first cousin who had mucoviscidosis. The pathophysiologic problem underlying the symptoms of this disease is:

Correct Answer: C

Rationale: The correct answer is C) Production of abnormally tenacious secretions by the exocrine glands. This points to cystic fibrosis (CF), a genetic disorder that affects the exocrine glands, causing them to produce thick and sticky mucus. In Sonya's case, the symptoms of foul-smelling, frothy stools, failure to thrive, bronchitis, and a family history of mucoviscidosis all point towards CF. The thick mucus can block the airways, leading to respiratory issues like bronchitis and cough. Option A) Sluggish lymph circulation due to increased tortuosity of vessels is incorrect. CF primarily affects the exocrine glands, not lymph circulation. Option B) Hypertrophy of smooth muscle fiber surrounding tubular structures is incorrect. This is not a characteristic feature of CF. Option D) Obstructions of granular ducts by uric acid is incorrect. Uric acid is not associated with CF or its pathophysiology. In an educational context, understanding the pathophysiology of CF is crucial for nurses caring for pediatric patients with respiratory disorders. Recognizing the signs and symptoms early can lead to prompt diagnosis and intervention, improving outcomes for patients like Sonya. Nurses play a key role in educating families about genetic disorders, facilitating early detection, and providing comprehensive care for children with CF.

Correct Answer: C

Rationale: In pediatric nursing, understanding the causes of childhood hearing loss is crucial for providing effective care and education to parents. The most common cause of hearing impairment in children is chronic otitis media, which is inflammation of the middle ear. This condition can lead to fluid build-up, infection, and damage to the ear structures, ultimately affecting hearing. Option A, congenital rubella, can cause hearing loss in children but is not as common as chronic otitis media. Option B, congenital ear defects, may also lead to hearing impairment but is not the most prevalent cause. Option D, auditory nerve damage, is a less common cause of hearing loss in children compared to chronic otitis media. Educationally, it is important for nurses to emphasize the significance of timely diagnosis and treatment of chronic otitis media to prevent long-term hearing issues in children. Parents should be educated on the signs and symptoms of ear infections, the importance of seeking medical attention promptly, and strategies for preventing recurrent infections. This knowledge empowers parents to advocate for their child's hearing health and well-being.

Correct Answer: D

Rationale: The correct answer is D) Speech development. Early detection of hearing impairment is crucial because it directly impacts a child's ability to develop speech and language skills. Hearing loss can significantly hinder a child's speech production, articulation, vocabulary development, and overall communication abilities. Without timely intervention, children with hearing impairments may experience delays in language acquisition and struggle to communicate effectively, which can lead to social, emotional, and academic challenges. Option A) Reading development is not the most critical importance in this context because although hearing impairment can impact a child's ability to learn phonics and auditory processing necessary for reading, speech development is more fundamental for overall communication. Option B) Relationships with peers can also be affected by hearing impairment, but clear communication through speech is essential for establishing and maintaining relationships with peers. Option C) Performance at school can be influenced by hearing impairment, particularly in understanding instructions, participating in class discussions, and academic progress. However, without proper speech development, a child may face even greater obstacles in academic settings due to difficulties in expressing themselves and comprehending spoken language. Educationally, understanding the significance of early detection of hearing impairment in children is crucial for healthcare professionals, educators, and parents to ensure appropriate interventions are implemented to support the child's speech and language development, social interactions, and academic success. Early identification and intervention can significantly improve outcomes for children with hearing impairments, enabling them to reach their full potential and thrive in various aspects of their lives.

Correct Answer: B

Rationale: In this question, the correct answer is B) Myopia. Myopia is a refractive error where light rays focus in front of the retina instead of directly on it. This causes distant objects to appear blurry. The eyeball in myopia is longer than normal or the cornea has too much curvature. Amblyopia (A) is commonly known as lazy eye and refers to reduced vision in one eye. It is not a refractive disorder related to light rays falling in front of the retina. Cataract (C) is a clouding of the eye's lens, causing vision loss, but it is not a refractive disorder related to the position of light rays on the retina. Glaucoma (D) is a condition where increased pressure within the eye damages the optic nerve, leading to vision loss. It is not a refractive disorder related to the position of light rays on the retina. Educational Context: Understanding common pediatric respiratory disorders like myopia is crucial for nurses caring for pediatric patients. Recognizing these disorders helps in providing appropriate care, educating patients and families, and collaborating effectively with ophthalmologists. Nurses must be able to differentiate between various eye conditions to ensure early identification and management, promoting optimal health outcomes for pediatric patients.

Correct Answer: D

Rationale: In the context of pediatric nursing, minimizing separation anxiety in hospitalized toddlers is crucial for their emotional well-being and recovery. The correct answer, "D) Encourage parents to room-in," is the most appropriate nursing intervention for several reasons. Rooming-in allows the child to have familiar faces and comforting presence nearby, which can significantly reduce feelings of fear and anxiety associated with separation from parents. This practice promotes a sense of security, continuity of care, and supports the child's emotional needs during a stressful hospitalization period. Option A, "Explain procedures and routines," while important for providing information and structure, may not directly address the emotional distress caused by separation from parents. Children at this age are more likely to seek comfort and reassurance from familiar caregivers rather than understanding complex procedures. Option B, "Encourage contact with children the same age," is beneficial for social interaction and peer support, but it may not effectively address the immediate needs of a toddler experiencing separation anxiety from their parents. Option C, "Provide for privacy," is not directly related to addressing separation anxiety in a hospitalized toddler. Privacy is important for dignity and respect, but it may not alleviate the child's distress related to parental separation. In an educational context, understanding the emotional needs of pediatric patients is fundamental for nursing care. By choosing the correct intervention of encouraging parents to room-in, nurses can create a supportive environment that prioritizes the emotional well-being of hospitalized toddlers. This approach not only helps in managing separation anxiety but also fosters a sense of security and comfort for the child during a challenging healthcare experience.