The death of the infant described in Question 5 could have been prevented by which one of the following measures?

Correct Answer: A

Rationale: In the case of preventing the death of an infant, administering AquaMEPHYTON (vitamin K) at birth is the correct answer. This is because vitamin K deficiency can lead to a serious condition called Hemorrhagic Disease of the Newborn (HDN), which can result in life-threatening bleeding. Administering vitamin K at birth helps prevent this deficiency and subsequent complications. Home-visitor services (Option B) may be beneficial for overall infant health and well-being but would not directly prevent the specific condition related to vitamin K deficiency. Discontinuing antibiotics (Option C) or ensuring the proper use of an infant seat (Option D) are not relevant to preventing vitamin K deficiency-related complications. In an educational context, it is crucial for healthcare providers, especially pediatric nurses, to be well-versed in the importance of administering vitamin K at birth to prevent HDN. Understanding the rationale behind this preventive measure ensures that infants are provided with the necessary care to promote their health and well-being. This knowledge is essential for pediatric nurses to effectively advocate for evidence-based practices that can save lives and prevent avoidable complications in newborns.

Correct Answer: C

Rationale: The correct answer is C) Start phototherapy. In this scenario, the infant is presenting with jaundice, an elevated serum total bilirubin level, and a direct bilirubin level within normal limits. Given that the Coombs test is negative, this indicates unconjugated hyperbilirubinemia, which is commonly seen in physiological jaundice in newborns. Phototherapy is the first-line treatment for unconjugated hyperbilirubinemia as it helps convert bilirubin into a form that can be excreted by the liver. Option A) Start phenobarbital is incorrect because phenobarbital is not the first-line treatment for this type of jaundice. Option B) Perform an exchange transfusion is incorrect as it is a more invasive procedure and is usually reserved for severe cases or when phototherapy fails. Option D) Stop breast-feeding is incorrect as breast milk jaundice is a different condition and continuing breastfeeding is encouraged. Educationally, understanding the management of neonatal jaundice is crucial for pediatric nurses as it is a common condition in newborns. Recognizing the appropriate interventions based on the clinical presentation and test results is vital to providing safe and effective care for infants with jaundice. It is important to prioritize non-invasive treatments like phototherapy before considering more invasive options.

Correct Answer: D

Rationale: The correct answer is D) Administer magnesium sulfate. In this scenario, the infant is experiencing seizures with low blood glucose levels despite repeated administration of calcium gluconate. This suggests the seizures are likely due to hypocalcemia secondary to maternal diabetes rather than solely hypoglycemia. Magnesium sulfate is the appropriate treatment for hypocalcemia-related seizures in neonates. Choice A) Administering glucose would only address hypoglycemia, not the underlying cause of seizures in this case. Choice B) Administering pyridoxine is used for seizures associated with pyridoxine-dependent epilepsy, which is not indicated here. Choice C) Administering calcium would not be effective as repeated calcium gluconate administration did not resolve the seizures, indicating the issue is likely not solely related to calcium deficiency. Educationally, this question reinforces the importance of considering potential causes of seizures in neonates beyond hypoglycemia, such as hypocalcemia in this case. It highlights the need for a systematic approach to diagnosing and treating neonatal seizures to ensure appropriate management and optimal outcomes.

Correct Answer: B

Rationale: In this scenario of a 2-year-old girl with thumb sucking behavior, the best response is to choose option B) Ignore the behavior. This is because thumb sucking is a common self-soothing behavior in young children and typically resolves on its own without intervention. By ignoring the behavior, the child is given the opportunity to outgrow it naturally without drawing attention to it or causing undue stress. Option A) Reassurance to the mother may not be the most appropriate response as it can inadvertently draw more attention to the behavior, potentially reinforcing it. It is important to educate parents about the normalcy of thumb sucking and provide reassurance that most children will stop on their own. Option C) Use of bitter ointments is not recommended for managing thumb sucking in young children as it may not be developmentally appropriate and could introduce unnecessary negative associations with the behavior. Option D) Encouraging resolution may not be necessary at this stage as most children will naturally stop thumb sucking as they grow older and find alternative coping mechanisms. It is essential to provide parents with guidance on when and how to intervene if the behavior persists or causes issues with dental development. In an educational context, understanding typical childhood behaviors like thumb sucking is vital for pediatric nurses. By recognizing the developmental aspects of behaviors, nurses can provide appropriate guidance to parents and caregivers, promoting healthy child development and minimizing unnecessary interventions. Ignoring harmless behaviors like thumb sucking can often be the most effective and least intrusive approach in supporting children's natural growth and development.

Correct Answer: A

Rationale: In this question, the correct answer is A) It is normal behavior in young children. Truancy is defined as the act of staying away from school without permission. In young children, truancy is not considered normal behavior as they are typically under the supervision of parents or caregivers who ensure they attend school regularly. Option B) It represents disorganization within the home is incorrect because truancy is more about the child's behavior rather than the organization within the home. Option C) It may reflect underlying child abuse is incorrect because while truancy can sometimes be a sign of other issues, such as abuse, it is not always the case. Option D) Adolescents may be at risk of substance abuse is incorrect because while truancy can be a risk factor for substance abuse, it is not the only factor. In an educational context, understanding the reasons behind truancy is important for pediatric nurses as they work with children and families. Recognizing the signs of truancy and its potential underlying causes can help nurses intervene early and provide appropriate support and resources to families in need. By understanding that truancy is not normal behavior in young children, nurses can better advocate for the well-being of their pediatric patients.