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

Correct Answer: A

Rationale: The correct answer is A) AquaMEPHYTON (vitamin K) at birth. Vitamin K is essential for blood clotting, and newborns are born with low levels, putting them at risk for Vitamin K deficiency bleeding (VKDB), which can lead to severe bleeding and even death. Administering AquaMEPHYTON at birth helps prevent VKDB and is a standard practice in newborn care. Option B) Home-visitor services, although important for overall infant health and well-being, would not directly prevent VKDB or the specific cause of death in this scenario. Option C) Discontinuing antibiotics is not relevant to preventing VKDB, as the issue here is related to Vitamin K deficiency. Option D) Proper use of an infant seat is crucial for preventing injuries during transportation but is not related to the prevention of VKDB. In an educational context, understanding the importance of administering Vitamin K at birth is crucial for healthcare providers working with newborns to ensure they receive appropriate care and prevent potentially life-threatening complications like VKDB. This knowledge is fundamental in pediatric nursing practice to promote the well-being of newborns and reduce preventable deaths.

Correct Answer: C

Rationale: In this scenario, the correct next step in the management of the child's condition is to start phototherapy (Option C). This is because the patient is presenting with elevated total bilirubin levels, indicative of hyperbilirubinemia, which can lead to complications like kernicterus if not promptly addressed. Phototherapy is the initial treatment for neonatal jaundice as it helps convert bilirubin into a form that can be easily excreted by the baby's body. Starting phenobarbital (Option A) is not the appropriate next step in this case because it does not directly address the elevated bilirubin levels. Performing an exchange transfusion (Option B) is a more invasive procedure that is typically reserved for severe cases of hyperbilirubinemia or when phototherapy fails. Stopping breast-feeding (Option D) is not necessary unless there are other specific reasons related to the mother's diet or medications that may be exacerbating the condition. Educationally, understanding the management of neonatal jaundice is crucial for pediatric nurses as it is a common condition seen in newborns. Recognizing the appropriate interventions based on the clinical presentation and lab results is essential to prevent complications and ensure optimal outcomes for the infant. Following evidence-based guidelines and protocols for the management of hyperbilirubinemia is key to providing safe and effective care for neonates.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Administer magnesium sulfate. The infant's seizures are likely due to hypocalcemia secondary to maternal diabetes. While calcium gluconate was given and did not improve the seizures, magnesium sulfate is the appropriate next step. Magnesium sulfate can help correct hypocalcemia by aiding in the mobilization of calcium from tissues. It is also used to treat seizures in infants with hypocalcemia. Option A) Administer glucose is incorrect because the infant's blood glucose level is already 8 mg/dL, which is not low enough to cause seizures. Giving more glucose could worsen the situation. Option B) Administer pyridoxine is incorrect as pyridoxine is used for treating seizures caused by vitamin B6 deficiency, not hypocalcemia. Option C) Administer is not a complete option and does not provide any relevant information. In an educational context, understanding the etiology of seizures in infants, especially in the context of maternal diabetes, is crucial for pediatric nurses. Knowing the appropriate interventions for hypocalcemia-related seizures, such as administering magnesium sulfate, can prevent further complications and improve patient outcomes. This case highlights the importance of thorough assessment, critical thinking, and prompt intervention in pediatric nursing practice.

Correct Answer: B

Rationale: In dealing with a 2-year-old girl exhibiting thumb-sucking behavior, the best response is to choose option B) Ignore the behavior. This is the correct answer because thumb-sucking is a common self-soothing behavior in young children and typically resolves on its own without intervention. Ignoring the behavior helps prevent giving it unnecessary attention or reinforcing it as a means of seeking attention. It is important to understand that most children outgrow thumb-sucking naturally as they mature and develop other coping mechanisms. Option A) Reassurance to the mother may not be the best response as it does not address the behavior directly and may inadvertently make the mother more anxious about the behavior. Option C) Using bitter ointments is not recommended for young children as it can be unpleasant, and there is no need for negative reinforcement in this situation. Option D) Encouraging resolution may put unnecessary pressure on the child and could potentially cause more anxiety around the behavior. In an educational context, understanding normal developmental behaviors in children is crucial for pediatric nurses. By choosing the appropriate response to behaviors like thumb-sucking, nurses can support healthy development and provide guidance to parents without unnecessary intervention. It is important to educate parents about typical behaviors and when intervention may be needed, promoting a holistic approach to pediatric care.

Correct Answer: A

Rationale: In this question about truancy in pediatric nursing practice, the correct answer is A) It is normal behavior in young children. Truancy is defined as the intentional, unjustified, or unauthorized absence from compulsory education. Young children typically do not have the autonomy or means to skip school on their own, so truancy is not considered normal behavior in this age group. Option B) It represents disorganization within the home is incorrect because while truancy can be a symptom of family issues, it is not always indicative of disorganization within the home. Truancy can have various causes, including social, psychological, or academic factors. Option C) It may reflect underlying child abuse is incorrect because while truancy can be associated with child abuse in some cases, it is not a definitive indicator of abuse. Child abuse can manifest in various ways, and truancy is just one potential sign among many. Option D) Adolescents may be at risk of substance abuse is incorrect because while truancy can be a risk factor for substance abuse in adolescents, it is not the only risk factor. There are multiple factors that can contribute to substance abuse in this age group, including peer pressure, mental health issues, and family dynamics. In an educational context, understanding the reasons behind truancy is crucial for pediatric nurses to provide holistic care to their patients. By recognizing the underlying causes of truancy, nurses can intervene early, collaborate with other professionals, and support children and families in addressing the root issues. This knowledge helps nurses promote the health and well-being of children and adolescents in their care.