The first permanent tooth to erupt is

Correct Answer: B

Rationale: The correct answer is B) molar at 6 years. The first permanent teeth to erupt are typically the first molars around the age of 6. This is because the first molars do not replace any primary teeth but instead emerge behind the last primary molars in the back of the mouth. Option A) central incisor at 6 years is incorrect because central incisors are typically the first primary teeth to erupt, not permanent teeth. Option C) premolar lower canine at 6-7 years is incorrect because premolars and canines are usually the second and third permanent teeth to erupt, respectively, after the first molars. Option D) upper canine at 6-7 years is incorrect because canines usually erupt after the premolars, not before them. In an educational context, understanding the sequence of tooth eruption is crucial for healthcare professionals working with pediatric patients. It helps in identifying normal growth and development, detecting potential issues early, and providing appropriate dental care. Educating parents about the timing of tooth eruption can also aid in promoting good oral hygiene practices from a young age.

Correct Answer: B

Rationale: The correct answer is B) Encourage his friends to visit him in the hospital. This option will most enhance the psychosocial development of the 16-year-old male with cystic fibrosis for several reasons. First, maintaining social connections with peers is crucial for adolescents' emotional well-being and sense of normalcy during hospitalization. Having friends visit can provide emotional support, reduce feelings of isolation, and boost morale, contributing positively to his psychosocial development. Option A) Fax his teacher and have homework sent in, while important for academic continuity, does not directly address the psychosocial needs of the patient. It focuses solely on academic concerns and overlooks the emotional support that friends can provide. Option C) Encouraging frequent visits from his grandparents, though beneficial in terms of family support, may not fully meet the socialization needs of a teenager who likely values interactions with peers more at this developmental stage. Option D) Allowing him unlimited phone use to contact friends is a good way for him to stay connected, but physical visits from friends can offer a more personal and immediate form of support that can positively impact his psychosocial well-being. In an educational context, understanding the psychosocial needs of pediatric patients is vital for healthcare providers, especially those specializing in pediatric care like Certified Pediatric Nurses. Encouraging social interactions and support systems for hospitalized adolescents can significantly impact their overall well-being and recovery. This question highlights the importance of considering holistic care that addresses not only the physical but also the psychosocial needs of young patients.

Correct Answer: C

Rationale: The best next step in managing a 7-year-old with continued bed-wetting at night is option C: Limit fluids in the evening and consider a reward system for dry nights. This option addresses common strategies recommended in pediatric nursing practice for managing nocturnal enuresis. Explanation of the correct answer: Limiting fluids in the evening helps reduce the likelihood of bed-wetting episodes by decreasing the amount of urine produced during the night. Implementing a reward system for dry nights positively reinforces the child's behavior and motivates them to stay dry. Explanation of why the other options are wrong: A) Option A suggests using DDAVP, a medication that decreases urine volume. While this medication is sometimes prescribed for bed-wetting, it is typically considered after behavioral interventions have been tried. B) Option B, being firm and showing the work involved in changing sheets, does not address the underlying causes of bed-wetting and may lead to increased stress for the child. D) Option D recommends bed-wetting alarms, which can be effective but are often used in conjunction with other strategies like fluid restriction and positive reinforcement. Educational context: In pediatric nursing, it is essential to approach bed-wetting with a holistic view that considers behavioral, environmental, and physiological factors. Educating parents on effective strategies like limiting fluids and implementing reward systems can empower them to support their child in managing bed-wetting successfully. By understanding the rationale behind these interventions, healthcare providers can offer comprehensive care to pediatric patients with enuresis.

Correct Answer: A

Rationale: In a 4-week-old with biliary atresia, the most expected finding would be option A: abdominal distention, enlarged liver and spleen, clay-colored stools, and tea-colored urine. Biliary atresia is a serious condition where there is a blockage in the bile ducts, leading to impaired bile flow and subsequent symptoms. Abdominal distention occurs due to the buildup of bile in the liver, leading to enlargement. Clay-colored stools and tea-colored urine are classic signs of obstruction in the biliary system. Option B is incorrect as bruises and hematuria are not typically associated with biliary atresia. Option C is also incorrect as yellow sclera/skin, oily skin, and prolonged bleeding times are more indicative of liver dysfunction or other conditions, not specifically biliary atresia. Option D is incorrect as biliary atresia typically presents with symptoms early on, although they may be subtle initially. Educationally, understanding the signs and symptoms of biliary atresia is crucial for pediatric nurses as early detection and intervention are essential for better outcomes. Nurses need to be able to recognize these specific manifestations to facilitate prompt diagnosis and treatment, ultimately improving the quality of care for infants with this condition.

Correct Answer: B

Rationale: The correct answer is B) head trauma. Head trauma is the second leading cause of mortality from physical abuse in children. This is because head injuries can be particularly severe, causing brain damage or even death. Children are especially vulnerable to head trauma due to their developing brains and skulls, making it a significant concern in cases of physical abuse. Option A) rib fractures, while a common finding in cases of physical abuse, are not typically a leading cause of mortality. They can be painful and dangerous but are not as immediately life-threatening as head trauma. Option C) abdominal injury can also be serious but is less likely to result in mortality compared to head trauma, which can have rapid and devastating effects on a child's health. Option D) hot tap water burn, though a serious concern in cases of neglect or abuse, is not as commonly associated with mortality as head trauma. Burns can cause severe pain and scarring, but they are generally more treatable compared to the potentially lethal consequences of head injuries. In an educational context, it is crucial for healthcare professionals, especially those working with children, to be able to recognize the signs of physical abuse and understand the potential risks associated with different types of injuries. Understanding the leading causes of mortality in cases of physical abuse can help professionals intervene early and effectively to protect children from harm.