The adolescent's inability to develop a sense of who he is and what he can become results in a sense of which of the following?

Correct Answer: D

Rationale: In the context of Erikson's psychosocial development stages, adolescents are in the identity versus role confusion stage. This stage involves exploring personal values, beliefs, and goals to form a coherent sense of self. Role diffusion, the correct answer, occurs when an adolescent is unable to integrate various roles and experiences into a unified sense of self, leading to confusion and uncertainty about their identity and future roles. Option A, shame, is not the correct answer because shame is associated with a sense of personal failure or inadequacy, often stemming from external judgments or societal norms, which is not the focus of this developmental stage. Option B, guilt, is also incorrect as guilt typically arises from specific behaviors or actions that violate one's own moral code, rather than a broader sense of identity confusion. Option C, inferiority, is not the best choice as it aligns more with Erikson's earlier stage of industry versus inferiority, which occurs in middle childhood. This stage focuses on developing competence in skills and tasks, rather than the identity exploration seen in adolescence. Educationally, understanding Erikson's stages of psychosocial development is crucial for nurses working with adolescents to support their holistic development. By grasping the unique challenges and tasks of each stage, nurses can provide appropriate guidance and interventions to help adolescents navigate this critical period of identity formation.

Correct Answer: A

Rationale: In the management of an infant with hypoxic-ischemic encephalopathy (HIE), the most important step is therapeutic hypothermia (Option A). Therapeutic hypothermia has been shown to significantly improve neurological outcomes in neonates with HIE by reducing brain injury and improving overall survival rates. It helps decrease metabolic rate, limit the release of harmful neurotransmitters, and reduce inflammation in the brain following hypoxic injury. Steroid therapy (Option B) is not typically indicated in the management of HIE. While steroids may be used in some neonatal conditions, they do not play a primary role in the treatment of HIE. Inhaled nitric oxide (Option C) is more commonly used in conditions such as persistent pulmonary hypertension of the newborn (PPHN) rather than in HIE. Nitric oxide is a potent pulmonary vasodilator and is used to improve oxygenation in neonates with PPHN. Blood transfusion (Option D) may be necessary in cases where there is severe anemia or blood loss contributing to hypoxia, but it is not the primary management strategy for HIE. Educationally, understanding the rationale behind the management of HIE is crucial for pediatric nursing practice. Therapeutic hypothermia is a well-established intervention supported by research evidence, and knowing when and why to implement it can significantly impact patient outcomes in neonatal care. Nurses must be aware of the appropriate treatments for specific conditions to provide safe and effective care to their pediatric patients.

Correct Answer: B

Rationale: In full-term neonates, the most common cause of respiratory distress is transient tachypnea of the newborn (TTN). TTN occurs due to inadequate absorption of fetal lung fluid after birth, leading to retention of fluid in the lungs and resulting in respiratory distress. This condition typically improves within 24-72 hours without specific treatment. Option A, meconium aspiration, occurs when a newborn inhales meconium-stained amniotic fluid before or during delivery. While this is a serious condition, it is less common than TTN in full-term neonates. Option C, respiratory distress syndrome (RDS), is more commonly seen in preterm neonates due to immature lung development. It is caused by a deficiency of surfactant in the lungs, leading to atelectasis and respiratory distress. Option D, infection, can cause respiratory distress in neonates, but it is not the most common cause in full-term infants. Infections may present with other signs and symptoms in addition to respiratory distress. Understanding the common causes of respiratory distress in neonates is crucial for nurses caring for newborns. Recognizing TTN as a common and usually self-limiting condition helps nurses provide appropriate care and reassurance to both the infant and their parents. It is essential to differentiate between these conditions to ensure timely and effective management of respiratory distress in neonates.

Correct Answer: B

Rationale: Neonatal Abstinence Syndrome (NAS) occurs in newborns exposed to addictive substances in utero, most commonly opioids. Morphine or methadone therapy is the appropriate intervention for a neonate with NAS because it helps manage withdrawal symptoms in a controlled manner, ensuring the infant's safety and comfort during detoxification. These medications are titrated based on the infant's symptoms, reducing the risk of seizures and other complications associated with withdrawal. Nutritional support is essential for infants with NAS to promote growth and development, but it does not directly address the withdrawal symptoms. Antibiotic therapy is not indicated unless there is a concurrent infection present. Continuous positive airway pressure is used for respiratory support and would not directly address the symptoms of NAS. Educationally, it is crucial for nursing students preparing for the NCLEX to understand the specific interventions and management strategies for neonates with NAS. This knowledge ensures safe and effective care for this vulnerable population, emphasizing the importance of pharmacological interventions tailored to the infant's needs and withdrawal symptoms. It also highlights the importance of monitoring and assessing neonates with NAS closely to provide individualized care.

Correct Answer: B

Rationale: In the management of a neonate with suspected congenital heart disease, the first step should be to perform an echocardiogram (Option B). This is crucial to confirm the diagnosis and determine the specific type of congenital heart defect present. Echocardiography provides detailed information about the structure and function of the heart, guiding further management decisions. Administering prostaglandin (Option A) is often the next step after confirming the diagnosis of certain congenital heart defects, as it helps maintain ductal patency and improve cardiac output. However, this should only be done after a definitive diagnosis via echocardiogram. Starting antibiotics (Option C) is not the initial step in managing congenital heart disease. While infection prevention is important in these patients, it is not the first priority in this scenario. Oxygen therapy (Option D) may be necessary if the neonate is hypoxic, but it does not address the underlying issue of congenital heart disease and should not be the first step in management. Educationally, understanding the stepwise approach to managing neonates with suspected congenital heart disease is crucial for nurses and healthcare providers working in pediatric settings. This knowledge ensures timely and appropriate interventions, leading to better outcomes for these vulnerable patients.