The diagnosis for the child described in Question 5 is most likely

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Hemorrhagic disease of the newborn. Hemorrhagic disease of the newborn is a condition characterized by bleeding in the first few days of life due to vitamin K deficiency, which can lead to serious complications if not treated promptly. This condition is common in infants who did not receive vitamin K prophylaxis at birth. Option A) Pyridoxine deficiency is incorrect because it is related to vitamin B6 deficiency, which does not typically present with bleeding in newborns. Option B) Severe scurvy is incorrect as scurvy is caused by vitamin C deficiency and is rare in newborns. Option D) Child abuse is incorrect in this context as the symptoms described are indicative of a medical condition (hemorrhagic disease of the newborn) rather than physical trauma. Educationally, understanding the importance of vitamin K administration to newborns is crucial for healthcare providers working in pediatric settings. This question highlights the significance of early recognition and management of hemorrhagic disease of the newborn to prevent serious complications such as intracranial hemorrhage. Healthcare professionals need to be vigilant in ensuring that newborns receive appropriate vitamin K supplementation to prevent this potentially life-threatening condition.

Correct Answer: D

Rationale: The correct answer is D) Hemoglobin electrophoresis. In this scenario, the infant presents with significant jaundice, pallor, and a palpable liver, which are indicative of hemolytic disease such as ABO or Rh incompatibility. Hemoglobin electrophoresis is not necessary at this point as the clinical presentation does not suggest a hemoglobinopathy. Option A) Total and direct bilirubin levels are essential to assess the severity of jaundice and determine if there is conjugated hyperbilirubinemia, which could indicate liver disease or biliary obstruction. Option B) CBC with RBC morphology is important to assess for anemia, hemolysis, or other hematologic abnormalities that could contribute to the jaundice. Option C) Reticulocyte count helps to differentiate between hemolysis and liver pathology as a cause of jaundice. Elevated reticulocyte count would support a diagnosis of hemolysis. In an educational context, understanding the appropriate diagnostic steps in evaluating neonatal jaundice is crucial for pediatric nursing practice. This question highlights the importance of considering differentials and selecting appropriate investigations based on the clinical presentation to provide optimal care for neonates.

Correct Answer: D

Rationale: In this scenario, the most appropriate therapy for the infant presenting with edema, rash, and alopecia post-extensive intestinal resection for necrotizing enterocolitis is option D: Administer zinc. Zinc deficiency is common in pediatric patients with malabsorption issues like short bowel syndrome post-intestinal resection. Zinc plays a crucial role in immune function, wound healing, and skin integrity. The symptoms described (edema, rash, alopecia) are consistent with zinc deficiency. Administering zinc supplementation can help alleviate these symptoms and support the infant's overall health and development. Option A (Administer salt-poor albumin) is incorrect because the symptoms presented are not indicative of a need for albumin administration. Option B (Increase the protein content in the hyperalimentation solution) is incorrect because the symptoms are not due to protein deficiency but rather a specific micronutrient deficiency. Option C (Administer recombinant alkaline phosphatase) is incorrect as it does not address the symptoms associated with zinc deficiency in this case. In an educational context, understanding the specific nutritional requirements of pediatric patients post-intestinal resection is crucial for providing optimal care. This case highlights the importance of recognizing the clinical manifestations of nutrient deficiencies and tailoring treatment strategies accordingly to promote the best outcomes for pediatric patients.

Correct Answer: A

Rationale: In pediatric nursing, understanding stereotypic movements is crucial for assessing and providing care for children. Stereotypic movements are repetitive, seemingly purposeless behaviors that may indicate underlying neurological or developmental conditions. In this question, the correct answer is A) Hand shaking. Hand shaking is not typically recognized as a stereotypic movement in the context of pediatric nursing. Eye blinking, head banging, and self-biting are commonly known stereotypic movements observed in children with various developmental disorders like autism spectrum disorder, Tourette syndrome, or intellectual disabilities. Educationally, it is important for nursing students to differentiate between stereotypic movements to accurately assess and intervene for their pediatric patients. Understanding the nuances of these movements can help identify underlying conditions, tailor care plans, and advocate for appropriate interventions. It also enables nurses to educate families about these behaviors and provide support and resources for managing them effectively. Being able to discern between different types of stereotypic movements enhances the quality of care provided to children with complex needs.

Correct Answer: B

Rationale: In pediatric nursing, understanding the behavior of children, including lying, is crucial for providing appropriate care. The correct answer, B) It indicates a potential for future lying behavior, is true because frequent lying in a 3-year-old may not necessarily predict future lying tendencies. At this age, children are still developing a sense of reality and fantasy, and their imaginative play may involve storytelling that is not intended to deceive. Option A) It is a method of playing with language, is incorrect because while children may use language creatively in play, lying typically involves intentionally deceiving others, which is not the primary goal of a 3-year-old's behavior. Option C) It is a part of magical thinking, is incorrect as well. Magical thinking in children involves believing in fantasy or supernatural events, not necessarily intentional deception through lying. Option D) It is an approach to avoid unwanted confrontation with adults, is also incorrect because at age 3, children may not have developed the cognitive skills to strategize lying as a means to avoid confrontation. In an educational context, it is important for healthcare providers to understand the developmental stages of children to interpret their behaviors accurately. By recognizing that frequent lying in a young child is often linked to their cognitive and imaginative development rather than a precursor to future dishonesty, healthcare professionals can provide appropriate guidance and support to both the child and their caregivers.