The first factor to be affected by deficiency of vitamin K is

Correct Answer: C

Rationale: In pediatric gastrointestinal nursing, understanding the role of vitamin K is crucial as its deficiency can lead to bleeding disorders. The correct answer is C) Factor VII. Vitamin K is essential for the synthesis of clotting factors in the liver, with Factor VII being one of them. Without sufficient vitamin K, Factor VII levels decrease, leading to impaired blood clotting and an increased risk of bleeding. Option A) Factor I is fibrinogen, which is not primarily dependent on vitamin K for its synthesis. Option B) Factor II is prothrombin, another clotting factor synthesized with the help of vitamin K, but Factor VII is the first factor to be affected by vitamin K deficiency. Option D) Factor IX is also dependent on vitamin K for synthesis, but it is not the first factor affected. Understanding the sequence of clotting factors affected by vitamin K deficiency is essential in managing bleeding disorders in pediatric patients. Educationally, this question highlights the importance of vitamin K in pediatric gastrointestinal nursing and emphasizes the need for nurses to recognize the early signs of vitamin K deficiency to prevent serious complications like hemorrhage in pediatric patients. By understanding the specific clotting factors affected by vitamin K deficiency, nurses can intervene promptly and effectively to ensure optimal patient outcomes.

Correct Answer: C

Rationale: The correct answer is C) dental x-ray to look for intrusion. This option is the most appropriate next step because it helps in assessing if the missing tooth has been intruded into the jawbone due to the blunt trauma. Dental x-rays can provide valuable information on the exact location of the tooth and guide further treatment decisions. Option A) plan for a bridge is incorrect as it is premature to consider this without confirming the status of the missing tooth. Option B) abdominal x-ray to search for the avulsed tooth is not relevant as a dental x-ray is more specific for evaluating dental structures. Option D) ceramic tooth is also not appropriate as it jumps to a treatment modality without first establishing the diagnosis. Educationally, this scenario highlights the importance of proper assessment and diagnostic procedures in pediatric patients following traumatic dental injuries. It emphasizes the need for healthcare providers to follow a systematic approach to ensure accurate evaluation and appropriate management, considering the unique characteristics of pediatric patients.

Correct Answer: D

Rationale: In this question, the correct answer is D) eosinophilic gastritis as it is not an acquired cause of gastric outlet obstruction. Eosinophilic gastritis is a condition characterized by an increased number of eosinophils in the stomach lining, leading to inflammation, but it does not typically result in gastric outlet obstruction. A) Cystic fibrosis is an acquired cause of gastric outlet obstruction due to the thickening of secretions that can block the outlet. B) Epidermolysis bullosa can lead to esophageal strictures and subsequent gastric outlet obstruction due to scarring in the esophagus. C) Prostaglandin E infusions can cause gastric outlet obstruction by inducing smooth muscle relaxation in the gastrointestinal tract, leading to a functional obstruction. In an educational context, understanding the various acquired causes of gastric outlet obstruction is crucial for pediatric gastrointestinal nursing interventions. Recognizing the differences between conditions like cystic fibrosis, epidermolysis bullosa, and the effects of prostaglandin E infusions can aid nurses in providing appropriate care and interventions for pediatric patients with these conditions.

Correct Answer: C

Rationale: The correct answer is C) intussusception. Intussusception is a medical emergency in infants where one part of the intestine slides into another, causing obstruction and potentially cutting off the blood supply to that part of the intestine. The symptoms described in the scenario, such as fussiness, emesis, refusing to eat, difficult to arouse, abdominal distention, and occult blood in the stool, are classic signs of intussusception in infants. Option A) food poisoning typically presents with symptoms like nausea, vomiting, diarrhea, and fever, but it wouldn't explain the other symptoms and signs mentioned in the scenario. Option B) colic is characterized by excessive crying and fussiness in infants without a known cause, but it wouldn't explain the presence of occult blood in the stool and difficulty in arousing the infant. Option D) infant botulism is a rare but serious condition caused by bacterial spores that produce toxins leading to muscle weakness and difficulty feeding, but it doesn't typically present with the acute onset and specific symptoms described in the scenario. Educationally, understanding the differentiation of gastrointestinal conditions in infants is crucial for pediatric healthcare providers. Recognizing the signs and symptoms of intussusception promptly is essential as delayed diagnosis and treatment can lead to serious complications such as bowel perforation. This case highlights the importance of thorough assessment and clinical reasoning in pediatric nursing practice.

Correct Answer: B

Rationale: The correct answer to the question is B) Crohn disease carries a higher risk of malignancy than does ulcerative colitis. This is because Crohn's disease, a type of inflammatory bowel disease (IBD), is associated with a higher risk of developing colorectal cancer compared to ulcerative colitis. This is due to the fact that Crohn's disease can affect any part of the gastrointestinal tract, leading to a higher likelihood of complications such as strictures and fistulas, which can increase the risk of malignancy. Option A is incorrect because there is indeed a genetic component to IBD, and having a family member with IBD increases the risk of developing the disease. Option C is incorrect as both Crohn's disease and ulcerative colitis are types of IBD that can run in families, so it is possible for both diseases to be present in the same family. Option D is incorrect as there is no known association between IBD and glycogen storage disease type 1b. It is important for nurses caring for pediatric patients with gastrointestinal conditions to understand the differences between Crohn's disease and ulcerative colitis, as this knowledge guides appropriate nursing interventions and helps in providing comprehensive care to these patients.