Stage 1 hypertension in children is defined as:

Correct Answer: D

Rationale: In pediatric nursing, understanding blood pressure (BP) ranges and classifications is crucial for early detection and management of hypertension. Stage 1 hypertension in children is defined as average SBP or DBP levels between the 95th and 99th percentile for age, sex, and height on multiple occasions. This means the correct answer is D. Option A (average SBP or DBP levels <90th percentile) is incorrect because this range is considered normal BP in children. Option B (average SBP or DBP levels > 99th percentile) is incorrect as it would indicate severe hypertension. Option C (BP > 120/80) is not specific to pediatric hypertension criteria. Educationally, this question highlights the importance of accurate BP measurements in children and the need to interpret them based on age-specific percentiles. Understanding these classifications helps nurses identify and intervene early in hypertension cases, preventing long-term cardiovascular complications. Regular monitoring, proper technique, and knowledge of pediatric BP norms are essential skills for pediatric nurses.

Correct Answer: D

Rationale: In pediatric nursing, understanding the manifestations of rheumatic fever with carditis is crucial for early recognition and appropriate intervention. The correct answer, D) Apical mid-diastolic rumbling murmur with pre-systolic accentuation, is incorrect because this is actually a characteristic finding in rheumatic carditis due to mitral valve involvement. Option A) Tachycardia out of proportion to fever is a common manifestation of carditis as the heart works harder to compensate for inflammation. Option B) Pericardial rub is associated with pericarditis, not rheumatic carditis. Option C) Heart failure can occur due to the strain on the heart from inflammation and damage caused by rheumatic fever. Educationally, understanding these distinctions is important for nurses caring for pediatric patients at risk for rheumatic fever. Recognizing these signs early can lead to prompt treatment and prevention of further cardiac damage. It is essential for nurses to be able to differentiate between various cardiac sounds and symptoms to provide optimal care for their patients.

Correct Answer: C

Rationale: Acute laryngotracheobronchitis, also known as croup, is a common respiratory condition in children characterized by inflammation of the larynx, trachea, and bronchi. The radiological sign associated with acute laryngotracheobronchitis is the "steeple sign," which refers to the characteristic subglottic narrowing and tapered appearance on imaging studies. This sign is indicative of the narrowing of the airway at the level of the cricoid cartilage, a hallmark feature of croup. Option A, generalized hyperinflation, is not typically seen in acute laryngotracheobronchitis. Hyperinflation is more commonly associated with conditions like asthma or chronic obstructive pulmonary disease. Option B, lobar consolidation, is not a typical finding in croup. Lobar consolidation is more commonly seen in conditions such as pneumonia, where there is a buildup of fluid or pus in a specific lobe of the lung. Option D, thumb sign, is associated with epiglottitis, another upper airway condition. The thumb sign refers to swelling of the epiglottis, leading to a thumb-like appearance on imaging studies. This finding is not specific to acute laryngotracheobronchitis. Understanding the radiological signs associated with different respiratory conditions is crucial for pediatric nurses in diagnosing and managing these conditions effectively. Recognizing the steeple sign in acute laryngotracheobronchitis can help healthcare providers initiate appropriate treatment promptly. It is essential for nurses to be able to differentiate between various radiological signs to provide optimal care for pediatric patients with respiratory illnesses.

Correct Answer: C

Rationale: In this scenario, the most likely diagnosis for a preterm infant presenting with sudden respiratory distress, decreased breath sounds, and increased transillumination on one side is C) Pneumothorax. A pneumothorax occurs when air leaks into the space between the lung and chest wall, causing lung collapse and subsequent respiratory distress. Transient tachypnea of the newborn (A) is characterized by rapid breathing due to retained lung fluid, typically resolving within 24-72 hours without decreased breath sounds or transillumination. Meconium aspiration syndrome (B) results from fetal distress causing the infant to pass meconium into the amniotic fluid, leading to airway obstruction and chemical pneumonitis, not pneumothorax. Neonatal pneumonia (D) presents with systemic signs of infection and may have abnormal breath sounds but is less likely to cause unilateral transillumination. Educational context: Understanding these differential diagnoses in pediatric nursing is crucial for timely and accurate intervention. Pneumothorax can be life-threatening in infants and requires immediate attention to prevent respiratory compromise. Nurses must be able to recognize the signs and symptoms of various respiratory conditions in neonates to provide prompt and effective care.

Correct Answer: D

Rationale: In this scenario, the most likely diagnosis for a neonate presenting with cyanosis that worsens with feeding and improves with crying is choanal atresia, making option D the correct answer. Choanal atresia is a congenital condition where there is a blockage of the nasal passage due to bony or membranous tissue, leading to difficulty breathing through the nose. When the neonate cries, they are able to improve oxygenation by breathing through their mouth, alleviating the cyanosis temporarily. Option A, Tetralogy of Fallot, is characterized by a set of four heart defects and typically presents with cyanosis that is not influenced by crying or feeding. Option B, Respiratory distress syndrome, usually presents with respiratory distress, tachypnea, and grunting, rather than the specific cyanosis pattern described in the question. Option C, Transposition of the great arteries, would present with severe cyanosis from birth and would not typically improve with crying. Educationally, understanding the different presentations of cyanosis in neonates is crucial for pediatric nurses to provide timely and appropriate care. Recognizing the specific signs and symptoms associated with various conditions allows for prompt intervention and treatment, ultimately improving patient outcomes. It is essential for nurses to have a solid foundation in pediatric conditions to accurately assess, diagnose, and intervene in neonatal emergencies.