The ductus arteriosus is another fetal structure that is important in the intrauterine life. It functions to:

Correct Answer: B

Rationale: The ductus arteriosus is a fetal blood vessel that connects the pulmonary artery to the aorta. Its main function is to bypass the non-functional fetal lungs by shunting blood from the pulmonary artery (which carries deoxygenated blood) directly to the systemic circulation, specifically the aorta. This allows oxygenated blood from the placenta to be distributed to the body's organs and tissues without having to first pass through the lungs for oxygen exchange. After birth, when the baby begins to breathe and oxygenate its blood through the lungs, the ductus arteriosus normally closes within the first few days to weeks of life.

Correct Answer: A

Rationale: Adequate cardiac output is a measure of how well the heart is able to pump blood effectively to meet the body's metabolic demands. An adequate cardiac output ensures sufficient oxygen and nutrients are delivered to the tissues and organs. One of the most reliable indicators of adequate cardiac output is urine output. A urine output of at least 1 mL/kg/hour, which translates to around 30 mL/hour in a 5-year-old child, indicates adequate perfusion and renal function. In heart failure, decreased cardiac output may lead to decreased renal perfusion, resulting in a decreased urine output, so a stable or increased urine output suggests adequate cardiac output.

Correct Answer: A

Rationale: In the context of Juvenile Rheumatoid Arthritis (JRA) where impaired physical mobility is a nursing diagnosis, the correct nursing intervention of giving pain medication prior to ambulation (Option A) is crucial. This intervention helps to manage the pain associated with movement, thereby promoting increased mobility and participation in activities. Assisting with range-of-motion activities (Option B) is also an appropriate nursing intervention as it helps prevent joint stiffness and contractures. This intervention promotes joint flexibility and maintains or improves the child's range of motion. Encouraging the child to eat a high-fat diet (Option C) is not a relevant nursing intervention for impaired physical mobility in JRA. A high-fat diet is not associated with improving mobility or managing symptoms of JRA. Providing oxygen as necessary (Option D) is also not directly related to addressing impaired physical mobility in JRA. Oxygen therapy may be needed for other respiratory or cardiovascular conditions but is not a primary intervention for impaired physical mobility in JRA. Educationally, understanding the rationale behind each nursing intervention is crucial for providing holistic care to pediatric patients with JRA. By selecting appropriate interventions, nurses can effectively support these patients in managing their condition and improving their quality of life.

Correct Answer: B

Rationale: When planning education for the parents of a child with type 1 diabetes mellitus, the nurse should include rotating insulin injection sites. This is important to prevent lipohypertrophy, which is the buildup of fat under the skin, and to ensure consistent absorption of insulin. Rotating injection sites helps to maintain healthy tissue and promotes better insulin effectiveness in managing blood sugar levels. It is a key component of proper diabetes care and helps to reduce the risk of complications associated with continuous injection in the same area.

Correct Answer: D

Rationale: The primary therapeutic management of children with beta-thalassemia major involves frequent blood transfusions. This is necessary because beta-thalassemia major is a severe form of thalassemia where there is a significant reduction in the production of hemoglobin. Blood transfusions help to increase the levels of normal hemoglobin in the body, improving symptoms related to anemia and preventing complications such as growth failure and organ damage. Other treatments such as iron chelation therapy to manage iron overload and supportive measures like adequate hydration are also important, but frequent blood transfusions are the cornerstone of managing beta-thalassemia major.