The best method for airway opening in an arrested child is

Correct Answer: B

Rationale: The correct answer is B) Endotracheal tube for opening the airway in an arrested child. When a child is in cardiac arrest, the most effective way to maintain an open airway and ensure adequate oxygenation is by inserting an endotracheal tube. This method allows for direct delivery of oxygen to the lungs and prevents obstruction of the airway. Option A) Oropharyngeal airway is commonly used for airway management in conscious or semi-conscious patients but is not suitable for an arrested child as it does not provide a secure airway. Option C) Head tilt and jaw thrust maneuver is used to open the airway in a patient with suspected cervical spine injury. In a child in cardiac arrest, this method may not be sufficient to establish and maintain a patent airway. Option D) Ryle tube is used for gastric decompression and enteral feeding, not for maintaining an airway in a child in cardiac arrest. In a pediatric nursing context, it is crucial for healthcare providers to be knowledgeable about the appropriate interventions during pediatric emergencies, including airway management in cardiac arrest situations. Understanding the rationale behind each airway opening method is essential for providing safe and effective care to pediatric patients in critical situations.

Correct Answer: B

Rationale: The correct answer is B) The murmur of mitral regurgitation has the same features as the murmur of VSD in timing. In pediatric nursing, understanding the characteristics of heart defects like ventricular septal defects (VSD) is crucial. In this case, the timing of the murmur is key. In VSD, the murmur is typically holosystolic, whereas in mitral regurgitation, the murmur is also holosystolic. This similarity in timing can sometimes make it challenging to differentiate between the two conditions based on auscultation alone. Now, let's explore why the other options are incorrect: A) Unrepaired large VSD is almost associated with normal growth pattern in infancy - This statement is incorrect as large unrepaired VSD can lead to significant complications such as congestive heart failure and failure to thrive due to the increased workload on the heart. C) A normal pulmonary vascularity in plain CXR is expected - This is incorrect as a large VSD can lead to increased pulmonary blood flow, causing pulmonary congestion and prominent pulmonary vascularity on a chest X-ray. D) The apical impulse is suggestive of right ventricular dilation - This is incorrect as in a large VSD, the increased blood flow typically causes left ventricular enlargement rather than right ventricular dilation. Educationally, understanding the subtle differences in murmur characteristics between different heart defects is essential for accurate assessment and diagnosis in pediatric nursing. It highlights the importance of thorough auscultation skills and knowledge of cardiac pathophysiology in providing quality care to pediatric patients with congenital heart defects.

Correct Answer: B

Rationale: In pediatric nursing, understanding auscultatory findings is crucial for accurate assessment and diagnosis. In this case, wide fixed splitting of the second heart sound is a classic finding in Atrial Septal Defect (ASD). This occurs due to the delayed closure of the pulmonic valve, resulting in a fixed split S2. Option A, Pulmonary Stenosis (PS), is incorrect because PS typically presents with a delayed or paradoxical split of S2. Option C, Aortic Stenosis (AS), is incorrect as AS would present with a single and loud S2. Option D, Ventricular Septal Defect (VSD), is incorrect as VSD typically does not affect the splitting of S2. Educationally, knowing these auscultatory findings aids in the differential diagnosis of pediatric cardiac conditions. Understanding the nuances between these conditions is vital for nurses caring for pediatric patients with congenital heart defects. Being able to interpret these findings accurately can lead to timely interventions and improved patient outcomes.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding indices of poor outcomes in fulminant hepatitis is crucial for providing appropriate care. The correct answer is B) Factor VII <8% of normal. Factor VII is a key clotting factor synthesized in the liver, and a severe deficiency indicates significant liver dysfunction, leading to poor outcomes such as bleeding diathesis and increased mortality. Option A) Increased prothrombin time response to vitamin K administration is incorrect because it may indicate vitamin K deficiency or impaired liver synthetic function but is not a specific index of poor outcome in fulminant hepatitis. Option C) Female sex is not a direct indicator of poor outcome in fulminant hepatitis. Gender alone does not determine the severity or prognosis of the condition. Option D) Hepatomegaly, while a common clinical finding in hepatitis, is not a specific index of poor outcome. Hepatomegaly can occur in various liver conditions and does not directly correlate with prognosis in fulminant hepatitis. Educationally, understanding these indices helps nurses in pediatric settings to recognize deteriorating conditions early, intervene promptly, and collaborate with the healthcare team to optimize patient outcomes. By grasping these nuanced indicators, nurses can provide holistic care and support to pediatric patients with fulminant hepatitis.

Correct Answer: C

Rationale: In pediatric nursing, understanding the prevalence of conditions like biliary atresia leading to neonatal cholestasis is crucial for early detection and intervention. The correct answer is option C) 25%. Biliary atresia is a rare condition accounting for approximately 25% of cases of neonatal cholestasis. This condition is characterized by the obstruction or absence of the bile ducts, leading to the build-up of bile in the liver. Option A) 30% and option B) 40% are higher percentages than the actual prevalence of biliary atresia causing neonatal cholestasis, which can lead to a misinterpretation of the frequency of this condition. Option D) 70% is significantly higher than the correct percentage and could lead to incorrect assumptions about the prevalence of biliary atresia in neonates. Educationally, understanding the correct prevalence of biliary atresia in neonates is crucial for healthcare professionals working with pediatric patients. This knowledge can guide clinical decision-making, prompt timely diagnostic evaluations, and facilitate appropriate referrals to specialists for further management. By providing accurate information in pediatric nursing review questions, educators can help reinforce key concepts and improve student comprehension in this specialized area of nursing practice.