The age at which the infant achieves early head control with bobbing motion when pulled to sit is

Correct Answer: B

Rationale: The correct answer is B) 3 months. Infants typically achieve early head control with a bobbing motion when pulled to sit around 3 months of age. At this stage, their neck muscles are strengthening, allowing them to better control their head movements. Option A) 2 months is too early for infants to have developed the necessary neck muscle strength for this milestone. At 2 months, infants are usually still developing their head control and are not able to exhibit the described bobbing motion. Option C) 4 months is slightly later than the typical age for achieving early head control with a bobbing motion. By 4 months, most infants have already mastered this skill and are progressing to more advanced forms of head control and movement. Option D) 6 months is beyond the expected age for achieving this milestone. By 6 months, infants should have already developed more advanced head control abilities and be working on sitting independently rather than just achieving head control when pulled to sit. Understanding developmental milestones in infants is crucial for pediatric nurses as it helps in monitoring children's growth and development, identifying any potential delays or issues early on, and providing appropriate support and interventions. By knowing the expected ages for different milestones, nurses can better assess and support the health and well-being of infants in their care.

Correct Answer: B

Rationale: The correct answer is B) Duchenne muscular dystrophy. Duchenne muscular dystrophy is an X-linked recessive disorder characterized by progressive muscle weakness, particularly in the pelvic and shoulder girdle muscles. The hypertrophy of calf muscles seen in this condition is due to muscle degeneration and fibrosis. The trendelenburg gait, where the child sways side to side while walking, is a common manifestation of Duchenne muscular dystrophy due to weakness in the hip muscles. Option A) Becker's muscular dystrophy is similar to Duchenne muscular dystrophy but has a milder course and later onset. It does not typically present with calf muscle hypertrophy seen in this case. Option C) Myotonic muscular dystrophy is characterized by myotonia (prolonged muscle contractions) and muscle wasting, not hypertrophy of calf muscles. Option D) Cerebral palsy is a neurological disorder that affects movement and muscle coordination but does not typically present with calf muscle hypertrophy and trendelenburg gait seen in Duchenne muscular dystrophy. Understanding these distinctions is crucial for pediatric nurses to accurately assess and manage children with neuromuscular disorders. Recognizing the specific signs and symptoms of each condition allows for early intervention and appropriate support for patients and their families.

Correct Answer: B

Rationale: The correct answer is B) Encourage his friends to visit him in the hospital. This option will most enhance the psychosocial development of the 16-year-old male with cystic fibrosis for several reasons. First, maintaining social connections with peers is crucial for adolescents' emotional well-being and sense of normalcy during hospitalization. Having friends visit can provide emotional support, reduce feelings of isolation, and boost morale, contributing positively to his psychosocial development. Option A) Fax his teacher and have homework sent in, while important for academic continuity, does not directly address the psychosocial needs of the patient. It focuses solely on academic concerns and overlooks the emotional support that friends can provide. Option C) Encouraging frequent visits from his grandparents, though beneficial in terms of family support, may not fully meet the socialization needs of a teenager who likely values interactions with peers more at this developmental stage. Option D) Allowing him unlimited phone use to contact friends is a good way for him to stay connected, but physical visits from friends can offer a more personal and immediate form of support that can positively impact his psychosocial well-being. In an educational context, understanding the psychosocial needs of pediatric patients is vital for healthcare providers, especially those specializing in pediatric care like Certified Pediatric Nurses. Encouraging social interactions and support systems for hospitalized adolescents can significantly impact their overall well-being and recovery. This question highlights the importance of considering holistic care that addresses not only the physical but also the psychosocial needs of young patients.

Correct Answer: C

Rationale: The best next step in managing a 7-year-old with continued bed-wetting at night is option C: Limit fluids in the evening and consider a reward system for dry nights. This option addresses common strategies recommended in pediatric nursing practice for managing nocturnal enuresis. Explanation of the correct answer: Limiting fluids in the evening helps reduce the likelihood of bed-wetting episodes by decreasing the amount of urine produced during the night. Implementing a reward system for dry nights positively reinforces the child's behavior and motivates them to stay dry. Explanation of why the other options are wrong: A) Option A suggests using DDAVP, a medication that decreases urine volume. While this medication is sometimes prescribed for bed-wetting, it is typically considered after behavioral interventions have been tried. B) Option B, being firm and showing the work involved in changing sheets, does not address the underlying causes of bed-wetting and may lead to increased stress for the child. D) Option D recommends bed-wetting alarms, which can be effective but are often used in conjunction with other strategies like fluid restriction and positive reinforcement. Educational context: In pediatric nursing, it is essential to approach bed-wetting with a holistic view that considers behavioral, environmental, and physiological factors. Educating parents on effective strategies like limiting fluids and implementing reward systems can empower them to support their child in managing bed-wetting successfully. By understanding the rationale behind these interventions, healthcare providers can offer comprehensive care to pediatric patients with enuresis.

Correct Answer: A

Rationale: In a 4-week-old with biliary atresia, the most expected finding would be option A: abdominal distention, enlarged liver and spleen, clay-colored stools, and tea-colored urine. Biliary atresia is a serious condition where there is a blockage in the bile ducts, leading to impaired bile flow and subsequent symptoms. Abdominal distention occurs due to the buildup of bile in the liver, leading to enlargement. Clay-colored stools and tea-colored urine are classic signs of obstruction in the biliary system. Option B is incorrect as bruises and hematuria are not typically associated with biliary atresia. Option C is also incorrect as yellow sclera/skin, oily skin, and prolonged bleeding times are more indicative of liver dysfunction or other conditions, not specifically biliary atresia. Option D is incorrect as biliary atresia typically presents with symptoms early on, although they may be subtle initially. Educationally, understanding the signs and symptoms of biliary atresia is crucial for pediatric nurses as early detection and intervention are essential for better outcomes. Nurses need to be able to recognize these specific manifestations to facilitate prompt diagnosis and treatment, ultimately improving the quality of care for infants with this condition.