The following are clinical manifestations of primary ciliary dyskinesia (PCD) EXCEPT:

Correct Answer: D

Rationale: Primary ciliary dyskinesia (PCD) is a genetic disorder that affects the cilia in the respiratory tract, leading to impaired mucociliary clearance. The correct answer, D) Retinitis pigmentosa, is not a clinical manifestation of PCD. Retinitis pigmentosa is a degenerative eye disease that affects the retina and is not associated with PCD. A) Recurrent pneumonia is a common clinical manifestation of PCD due to impaired clearance of respiratory secretions, leading to frequent respiratory infections. B) Chronic otitis media is also commonly seen in PCD due to dysfunctional cilia in the middle ear, leading to recurrent ear infections. C) Chronic pansinusitis is another manifestation of PCD due to impaired clearance of mucus from the sinuses, leading to chronic sinus infections. In an educational context, understanding the clinical manifestations of PCD is crucial for nurses caring for pediatric patients with respiratory conditions. Recognizing these signs and symptoms can help in early identification, appropriate management, and improving patient outcomes. Nurses should be aware of the key features of PCD to provide comprehensive care and support to children and families affected by this condition.

Correct Answer: A

Rationale: The least likely cause of hemothorax in children is costal exostoses (Option A). Costal exostoses are benign bony growths on the ribs and are not typically associated with the development of hemothorax. Rupture of an aneurysm (Option B) can lead to hemothorax due to the leakage of blood into the thoracic cavity. Blood dyscrasias (Option C), such as hemophilia or thrombocytopenia, can result in impaired clotting mechanisms, increasing the risk of hemothorax. Intrathoracic neoplasms (Option D), such as lung cancer or metastatic tumors, can cause bleeding into the pleural space, leading to hemothorax. Educationally, understanding the various causes of hemothorax in children is crucial for pediatric nurses preparing for the NCLEX exam. Recognizing the less common causes, like costal exostoses, helps nurses differentiate between potential etiologies of hemothorax and provide appropriate care and interventions based on the underlying cause.

Correct Answer: B

Rationale: In bronchopulmonary dysplasia (BPD), the most common physical finding on exam is tachypnea (Option B). This is because BPD is a chronic lung disease that primarily affects premature infants who have undergone mechanical ventilation and oxygen therapy. Tachypnea, or rapid breathing, is a hallmark sign of respiratory distress in these patients due to the impaired lung function and structural changes in the airways. Option A, dyspnea, may also be present in BPD, but tachypnea is more characteristic and prevalent in these patients. Dyspnea refers to difficult or labored breathing, which can occur in various respiratory conditions but is not as specific to BPD as tachypnea. Option C, mouth breathing, is not a primary physical finding in BPD. While some infants with respiratory issues may exhibit mouth breathing, it is not as common or specific to BPD as tachypnea. Option D, increased anteroposterior diameter of the chest, is more commonly associated with conditions like chronic obstructive pulmonary disease (COPD) or barrel chest in adults. In BPD, the chest may appear hyperinflated due to air trapping, but this is not typically described as an increased anteroposterior diameter. In an educational context, understanding the key physical findings in BPD is vital for nurses caring for premature infants in the neonatal intensive care unit (NICU). Recognizing tachypnea as a prominent sign of respiratory distress in BPD can help nurses provide timely interventions and support to optimize patient outcomes. This knowledge enhances the quality of care and improves patient safety in managing infants with BPD.

Correct Answer: B

Rationale: The correct answer is B) CD can include the entire gut from mouth to anus. In Crohn's disease (CD), inflammation can affect any part of the gastrointestinal tract from the mouth to the anus, leading to a variety of symptoms and complications. This distinguishes CD from ulcerative colitis (UC), which is limited to the colon. Understanding this distinction is crucial in diagnosing and managing these two types of inflammatory bowel diseases. Option A) UC involves only the colon is incorrect because UC is indeed limited to the colon, but CD can involve multiple regions of the gastrointestinal tract beyond the colon. Option C) Both A and B is incorrect because while UC involves only the colon, CD is the condition that can involve the entire gut from mouth to anus. Combining both statements is misleading and inaccurate. Option D) None of the above is incorrect as we have established that CD can involve the entire gastrointestinal tract, making option B the correct choice. Educationally, this question highlights the importance of recognizing the differences between UC and CD in terms of their patterns of gastrointestinal involvement. This knowledge is essential for healthcare professionals, especially nurses, who may encounter patients with these conditions in a clinical setting. Understanding these distinctions can aid in providing appropriate care, education, and support to patients with inflammatory bowel diseases.

Correct Answer: C

Rationale: In the context of pediatric respiratory health, monitoring factor V serially is crucial as it serves as a sensitive index of synthetic liver function. Factor V is a key clotting factor synthesized by the liver. Children with respiratory issues may face compromised liver function due to various reasons such as medications, infections, or congenital conditions. By measuring factor V levels, healthcare providers can assess the liver's ability to produce this essential clotting factor, which is vital for maintaining hemostasis and preventing bleeding complications. Option A, prothrombin time, and option B, partial thromboplastin time, are both important coagulation tests, but they do not directly assess the synthetic function of the liver like factor V does. These tests primarily evaluate the extrinsic and intrinsic pathways of the coagulation cascade, respectively, and are more indicative of clotting factors' activity rather than their production. Option D, synthetic function, is a broad term that encompasses various aspects of liver function, including the production of clotting factors like factor V. While monitoring synthetic function is essential, specifically measuring factor V provides a more direct and sensitive indicator of the liver's synthetic capacity in the context of coagulation. Understanding the significance of monitoring factor V levels in pediatric patients with respiratory issues is crucial for nurses and healthcare professionals caring for these vulnerable populations. It allows for early detection of potential liver dysfunction, enabling prompt interventions to prevent bleeding complications and improve patient outcomes.