The following are true regarding respiratory distress syndrome (RDS) EXCEPT

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding respiratory distress syndrome (RDS) is crucial for providing quality care to newborns. The correct answer, option B, states that in most cases, the symptoms and signs of RDS reach a peak within 7 days. This is incorrect because typically, the symptoms of RDS peak within the first 48-72 hours of life, not within 7 days. This delayed peak in symptoms is not characteristic of RDS. Option A is incorrect because signs of RDS usually appear within the first few hours, not minutes, of birth. Option C is incorrect because apnea and irregular respirations are common signs of respiratory distress in infants but they are not considered ominous signs specific to RDS. Option D is incorrect because improvement in RDS is typically not heralded by spontaneous diuresis but rather by improved oxygenation and respiratory effort. Educationally, understanding these nuances is vital for nurses caring for neonates with RDS. Prompt recognition of signs and symptoms, early intervention, and monitoring for improvement are key components of nursing care for infants with respiratory distress syndrome. Nurses must be diligent in assessing and managing respiratory conditions in neonates to optimize outcomes and prevent complications.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the causes of jaundice in newborns is crucial for early identification and intervention. In this case, the correct answer is D) congenital infections. Congenital infections such as toxoplasmosis, rubella, cytomegalovirus, and herpes (TORCH infections) can lead to jaundice in newborns. These infections can affect the liver's ability to process bilirubin, resulting in elevated levels and subsequent jaundice. Option A) erythroblastosis fetalis is a condition where there is a mismatch in blood types between the mother and baby, leading to the destruction of the baby's red blood cells and subsequent jaundice. Option B) Crigler-Najjar syndrome is a rare genetic disorder that impairs the ability of the liver to process bilirubin, leading to high levels and jaundice. Option C) concealed hemorrhage can also cause jaundice due to the release of excess hemoglobin into the bloodstream, overwhelming the liver's capacity to process bilirubin. Educationally, it is vital for pediatric nurses to be able to differentiate the various causes of neonatal jaundice to provide appropriate care and interventions. Understanding these different etiologies can guide nursing assessments, interventions, and patient education to ensure optimal outcomes for newborns with jaudice.

Correct Answer: C

Rationale: In pediatric nursing, understanding the indications for surgical repair of umbilical hernias is crucial for providing safe and effective care to pediatric patients. In this scenario, the correct answer is C) Hernias that appear before the age of 6 months. The rationale behind this is that umbilical hernias that manifest before the age of 6 months often resolve spontaneously as the infant grows and the abdominal muscles strengthen. Hence, immediate surgical intervention is not typically necessary in these cases. It is important for healthcare providers to monitor these hernias and assess for any changes in size or symptoms over time. Option A) If hernia persists to the age of 4-5 years is incorrect because umbilical hernias often resolve on their own before this age, and surgical intervention is usually not required unless complications arise. Option B) Causes symptoms is incorrect because the presence of symptoms such as pain or tenderness may indicate a need for surgical repair to prevent complications. Option D) Becomes strangulated is incorrect because if a hernia becomes incarcerated or strangulated, surgical intervention is necessary to prevent further complications and potential tissue damage. Educationally, this question highlights the importance of understanding the natural history of umbilical hernias in pediatric patients and the appropriate timing for surgical intervention. It emphasizes the need for healthcare providers to monitor hernias closely, intervene when necessary to prevent complications, and provide holistic care to pediatric patients with umbilical hernias.

Correct Answer: B

Rationale: In the context of pediatric nursing and the study of very low birth weight (VLBW) infants, understanding the association between specific pathogens and late-onset sepsis is crucial for providing effective care. In this case, the correct answer is B) 70%. The rationale behind this is that gram-positive agents are commonly implicated in cases of late-onset sepsis in VLBW infants. These pathogens, such as Staphylococcus epidermidis and Streptococcus species, are known to cause infections in neonatal populations due to their ability to colonize indwelling medical devices and breach the immature skin barrier of premature infants. Regarding why the other options are incorrect: - A) 90%: This is too high a percentage and does not accurately represent the typical distribution of gram-positive agents in late-onset sepsis cases. - C) 50%: This is lower than the actual association of gram-positive agents with late-onset sepsis in VLBW infants. - D) 30%: This percentage is too low and underestimates the prevalence of gram-positive agents in causing late-onset sepsis in this population. Educationally, knowing the common pathogens associated with specific conditions in pediatric nursing is essential for early recognition, diagnosis, and treatment. Understanding the microbial etiology of infections allows healthcare professionals to implement targeted interventions and antibiotic therapies to improve patient outcomes, especially in vulnerable populations like VLBW infants.

Correct Answer: B

Rationale: In pediatric nursing, understanding the significance of clinical manifestations is crucial for accurate diagnosis and treatment. Pneumatosis intestinalis refers to the presence of gas within the wall of the intestine, which is pathognomonic for necrotizing enterocolitis (NEC). NEC is a serious condition seen in premature infants, characterized by inflammation and necrosis of the bowel wall. The presence of pneumatosis intestinalis on imaging is a key diagnostic feature of NEC due to the gas produced by bacterial fermentation within the damaged bowel wall. Option A, Hirschsprung's disease, is a congenital disorder characterized by the absence of ganglion cells in the colon, leading to functional obstruction. Pneumatosis intestinalis is not typically associated with this condition. Option C, Pseudomembranous enterocolitis, is usually caused by Clostridium difficile infection and is characterized by the formation of pseudomembranes on the colonic mucosa. Pneumatosis intestinalis is not a typical feature of this condition. Option D, Neonatal ulcerative colitis, is a form of inflammatory bowel disease that can affect newborns. While it may present with similar symptoms as NEC, pneumatosis intestinalis is not specific to this condition. Educationally, understanding the specific clinical manifestations and diagnostic findings of pediatric gastrointestinal conditions like NEC is essential for nurses caring for infants in neonatal units. Recognizing the significance of pneumatosis intestinalis can prompt timely interventions and prevent serious complications associated with NEC. It emphasizes the importance of thorough assessment, prompt reporting of findings, and collaboration with the healthcare team to ensure optimal patient outcomes.