The first choice for diagnosis of pancreatic pseudocysts is

Correct Answer: A

Rationale: The correct answer is A) transabdominal ultrasonography for diagnosing pancreatic pseudocysts. Transabdominal ultrasonography is often the initial imaging modality of choice due to its non-invasiveness, cost-effectiveness, and ability to provide real-time imaging of the pancreas. It can effectively visualize fluid collections and help differentiate pseudocysts from other pancreatic pathologies. Option B) CT scanning is a valuable tool for further evaluation of pancreatic pseudocysts, providing detailed cross-sectional images. However, it is usually reserved for cases where ultrasonography results are inconclusive or further characterization is needed. Option C) Magnetic resonance cholangiopancreatography (MRCP) is not typically the first choice for diagnosing pancreatic pseudocysts. MRCP is more useful for evaluating biliary and pancreatic ductal anatomy rather than detecting pseudocysts. Option D) Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure that involves inserting a flexible tube into the duodenum to visualize the pancreatic and bile ducts. While it can be therapeutic for pseudocysts, it is not primarily used for initial diagnosis due to its invasiveness and potential complications. In an educational context, understanding the appropriate diagnostic approach for pancreatic pseudocysts is crucial for healthcare providers caring for pediatric patients with gastrointestinal disorders. Emphasizing the importance of selecting the most appropriate and least invasive imaging modality can lead to timely and accurate diagnosis, ultimately improving patient outcomes.

Correct Answer: A

Rationale: In pediatric gastrointestinal disorders, understanding hepatotropic viruses is crucial. The correct answer is A) HAV because Hepatitis A virus is primarily transmitted through the fecal-oral route via contaminated food or water. This mode of transmission does not involve parenteral (bloodborne) routes. HBV (option B) is transmitted through perinatal exposure, blood transfusions, sexual contact, and needle sharing, making it a bloodborne virus. HCV (option C) is also bloodborne and is commonly transmitted through shared needles or blood transfusions. HDV (option D) is a defective virus that requires HBV for transmission, making it also parenterally transmitted. Educationally, understanding the modes of transmission of hepatotropic viruses is essential for providing appropriate care, implementing preventive measures, and educating patients and families about disease prevention. This knowledge is vital for nursing practice, especially when caring for pediatric patients with gastrointestinal disorders.

Correct Answer: D

Rationale: HBV, or Hepatitis B Virus, is primarily spread through contact with infected blood or body fluids. Sharing needles, as in option D, is a high-risk behavior for HBV transmission due to direct blood contact. Kissing (option A) and hugging (option B) do not typically transmit HBV unless there are open sores or blood present. Sharing utensils (option C) can potentially transmit the virus if there is blood on the utensil, but it is a less common mode of transmission compared to direct blood contact via needle sharing. In an educational context, understanding how HBV is transmitted is crucial for healthcare professionals, especially when dealing with pediatric patients who may be more vulnerable to infections. By knowing the modes of transmission, healthcare providers can educate families on preventive measures to protect children from contracting HBV. This question reinforces the importance of safe practices and highlights the significance of infection control in pediatric care.

Correct Answer: D

Rationale: In this question, the correct answer is D) ceftriaxone. Ceftriaxone is associated with the development of biliary sludge or cholelithiasis in pediatric patients. This adverse effect is linked to the calcium salt formation in the gallbladder due to the breakdown of ceftriaxone into calcium complexes. This process can lead to the precipitation of calcium bilirubinate crystals, resulting in biliary sludge or gallstones. A) cefotaxime and B) meropenem are not typically associated with the formation of biliary sludge or cholelithiasis in pediatric patients. Vancomycin (C) is not known to cause this specific adverse effect. Educationally, it is important for healthcare providers to be aware of the potential side effects of medications commonly used in pediatric populations. Understanding the risks associated with certain antibiotics can help in making informed decisions when prescribing medications to children, ensuring their safety and well-being. It also highlights the importance of monitoring for adverse effects and considering alternative treatment options when necessary.

Correct Answer: A

Rationale: In this question, the correct answer is A) perforation of the appendix. Acute secondary peritonitis commonly follows the entry of enteric bacteria into the peritoneal cavity through a necrotic defect in the viscus, with the most common source being a perforated appendix. Rationale: Perforation of the appendix can lead to the release of fecal material and bacteria into the peritoneal cavity, causing peritonitis. The appendix is a common site for infection and inflammation, and if left untreated, it can rupture, leading to serious complications. Why the other options are incorrect: B) Rupture of a Meckel diverticulum is less common than appendiceal perforation as a cause of peritonitis. C) Intussusception is the telescoping of one part of the intestine into another and is not typically associated with peritonitis. D) Necrotizing enterocolitis is a condition primarily seen in premature infants and is not a common cause of peritonitis in the context described in the question. Educational context: Understanding the common causes of acute secondary peritonitis is crucial for healthcare professionals, especially those working with pediatric patients. Recognizing the signs and symptoms of peritonitis, along with its common etiologies, is essential for prompt diagnosis and treatment to prevent serious complications. This knowledge is particularly important in emergency and pediatric healthcare settings where timely intervention can be life-saving.