The following are true regarding apnea EXCEPT

Correct Answer: B

Rationale: In pediatric nursing, understanding apnea is crucial as it can be a life-threatening condition in infants. The correct answer, B) in term infants, apnea is always worrisome, is right because apnea in term infants can be a normal physiological event, especially during sleep, and may not always indicate a serious underlying issue. This distinction is important to prevent unnecessary alarm among parents and healthcare providers. Option A is incorrect because apnea is indeed a common problem in preterm infants due to their immature respiratory control. Option C is incorrect as it describes central apnea, not obstructive apnea, which is characterized by lack of chest wall movement. Option D is incorrect as serious apnea in infants is typically defined as cessation of breathing for longer than 20 seconds in preterm infants and longer than 15 seconds in term infants. In an educational context, it is essential for pediatric nurses to differentiate between normal and abnormal apnea patterns in infants to provide appropriate care and support. Understanding the nuances of apnea in different age groups and contexts is crucial for effective pediatric nursing practice and ensuring optimal patient outcomes.

Correct Answer: A

Rationale: In neonatal necrotizing enterocolitis (NEC), an absolute indication for surgery is a positive result of abdominal paracentesis (choice A). This diagnostic procedure helps identify the presence of free air or fluid in the peritoneal cavity, indicating bowel perforation, a severe complication requiring surgical intervention. Choice B, failure of medical management, is not an absolute indication for surgery in NEC as some cases may respond to conservative treatment such as bowel rest, antibiotics, and close monitoring. Choice C, a single fixed bowel loop on radiographs, may suggest NEC but does not definitively indicate the need for surgery. Surgical intervention is based on clinical assessment and other diagnostic findings. Choice D, a palpable mass, is not a specific or absolute indication for surgery in NEC. Surgical decisions are generally guided by clinical deterioration, radiographic findings, and clinical judgment rather than the presence of a palpable mass alone. Educationally, understanding the absolute indications for surgery in NEC is crucial for pediatric nurses caring for neonates at risk for this life-threatening condition. Recognizing the significance of abdominal paracentesis results in guiding timely surgical interventions can improve patient outcomes and prevent complications associated with NEC. It is essential for healthcare providers to be knowledgeable about the diagnostic and management strategies for NEC to provide optimal care for neonates in their practice.

Correct Answer: C

Rationale: The correct answer is C) Hemorrhagic disease of the newborn. The apt test, or activated partial thromboplastin time, is useful for diagnosing clotting disorders, specifically in this case, to assess for hemorrhagic disease of the newborn. This disease occurs due to vitamin K deficiency in newborns, leading to impaired clotting factors synthesis, which can manifest as bleeding issues. Option A) Disseminated intravascular coagulopathy (DIC) is a condition where clotting factors are consumed excessively, leading to both bleeding and clotting. The apt test may be prolonged in DIC, but it is not a specific diagnostic test for this condition. Option B) Swallowed blood syndrome is not a recognized medical condition, so it is an incorrect distractor. Option D) Neonatal thrombocytopenic purpura is a condition characterized by low platelet count and increased bleeding tendencies due to a decrease in platelet production or increased destruction. The apt test is not specific for diagnosing thrombocytopenia. In the context of pediatric nursing, understanding the diagnostic tests specific to various conditions is crucial for providing accurate and timely care to pediatric patients. By knowing the indications and interpretations of tests like the apt test, nurses can assist in the diagnosis and management of conditions affecting pediatric populations, ensuring better outcomes for their young patients.

Correct Answer: D

Rationale: In pediatric nursing, understanding the agents that commonly cause nosocomial neonatal infections is crucial for providing safe and effective care to newborns. The correct answer to this question is option D) Gonococci. Neisseria gonorrhoeae, the causative agent of gonorrhea, can be a significant threat in the hospital setting due to its transmission through contaminated hands, instruments, or other fomites. Option A) Group B streptococci is a common cause of early-onset neonatal sepsis but is typically acquired vertically from the mother rather than nosocomially. Option B) Coagulase-negative staphylococci are commonly found as part of the skin flora and may cause infections in neonates but are not typically associated with nosocomial infections. Option C) Proteus is not a common agent in nosocomial neonatal infections. Educationally, understanding the distinction between these pathogens is essential for nurses to implement appropriate infection control measures, such as hand hygiene and aseptic techniques, to prevent the spread of infections in the neonatal care setting. By knowing which organisms are more likely to cause nosocomial infections, healthcare providers can take proactive steps to safeguard the health of vulnerable newborns.

Correct Answer: C

Rationale: In pediatric nursing, understanding normal and abnormal umbilical cord physiology is crucial for identifying underlying abnormalities in newborns. The correct answer is C) 30 days. The umbilical cord typically detaches within 10-14 days after birth. Persistence beyond 30 days may indicate an underlying abnormality such as an umbilical granuloma, urachal remnant, or an umbilical hernia. Therefore, healthcare providers should consider further evaluation if the cord persists beyond 30 days to ensure the infant's health and well-being. Option A) 10 days is too early for concern as umbilical cord detachment within the first two weeks is considered normal. Option B) 20 days is also within the expected timeframe for cord detachment, so it would not necessarily prompt consideration of an abnormality. Option D) 40 days is too long to wait before investigating a potential issue with the umbilical cord, as prompt assessment and intervention are crucial in pediatric care. Educationally, understanding the normal progression of umbilical cord detachment and recognizing signs of abnormality is essential for pediatric nurses to provide comprehensive care to newborns. This knowledge helps in early identification and management of any underlying conditions, contributing to better health outcomes for infants.