The following factors suggest hemolytic disease as a cause of jaundice in the newborn EXCEPT

Correct Answer: D

Rationale: In pediatric nursing, understanding the causes of jaundice in newborns is crucial for early identification and intervention. In this scenario, the correct answer is option D, "Significant decrease in hemoglobin," as it is not typically associated with hemolytic disease. Option A, a bilirubin rise of >0.5 mg/dL/h, is indicative of hemolytic disease as increased bilirubin production is a hallmark. Option B, reticulocytosis >5% at birth, is also linked to hemolytic disease due to increased red blood cell turnover. Option C, onset of jaundice before 24 hours of age, is another characteristic feature of hemolytic disease since it presents early. Educationally, this question helps reinforce the key clinical manifestations and diagnostic criteria of hemolytic disease in newborns. By understanding these factors, nurses can promptly identify and manage neonates at risk for severe hyperbilirubinemia and its complications. This knowledge is essential for providing safe and effective care to newborns, highlighting the importance of thorough assessment and early intervention in neonatal nursing practice.

Correct Answer: D

Rationale: In pediatric nursing, understanding the differences in how posttraumatic stress disorder (PTSD) manifests in children versus adults is crucial for accurate assessment and intervention. In this scenario, the correct answer is D) exaggerated startle response, which is more likely to be seen in children with PTSD than in adults. Children often display heightened startle responses as a manifestation of their hyperarousal symptoms. This can present as being easily startled, jumpy, or hypervigilant, reflecting their heightened state of anxiety and fear following a traumatic event. The incorrect options can be explained as follows: A) Difficulty falling or staying asleep is a common symptom in both children and adults with PTSD, so it is not specifically more likely in children. B) Outbursts of anger can be seen in both children and adults with PTSD, although the way it manifests may differ based on developmental stages. C) Estrangement from others can occur in both children and adults with PTSD, so it is not a symptom that is more likely to be seen in children. Educationally, understanding these nuances is important for nurses working with pediatric populations to provide effective care and support for children experiencing PTSD. Recognizing age-specific manifestations can guide appropriate interventions and enhance outcomes for these vulnerable patients.

Correct Answer: B

Rationale: The correct answer is B) impaired communication and social interaction. This is because the hallmark feature of pervasive developmental disorders, including autism spectrum disorders (ASDs), is difficulties in social interaction and communication. Children with ASDs often struggle with understanding social cues, maintaining eye contact, engaging in reciprocal conversations, and forming meaningful relationships with others. Option A) onset is in infancy and preschool years is incorrect because while symptoms of ASDs typically appear in early childhood, they may not be recognized until later in life. Option C) mental retardation is incorrect because not all individuals with ASDs have intellectual disabilities, and it is not a defining characteristic of the disorder. Option D) aggression is incorrect because aggression is a behavior that can occur in individuals with ASDs, but it is not the hallmark feature of the disorder. In an educational context, understanding the hallmark features of ASDs is crucial for healthcare professionals working with pediatric patients. Recognizing and addressing communication and social interaction challenges early can lead to more effective interventions and support for children with ASDs. By knowing the key characteristics of pervasive developmental disorders, nurses can provide better care and support for these patients and their families.

Correct Answer: A

Rationale: In pediatric nursing, understanding common behaviors in children is essential to provide appropriate care and support. The correct answer is A) habit disorders that probably relieve tension. These behaviors, such as head banging, hair twirling, rocking, thumb sucking, teeth grinding, and nail biting, are often self-soothing mechanisms that children use to cope with stress or anxiety. Recognizing them as habit disorders helps healthcare providers approach them with empathy and support rather than judgment. Option B is incorrect because habit disorders are not always easy to cure in children. They may require understanding, patience, and sometimes professional intervention to help children develop alternative coping strategies. Option C is also incorrect as these behaviors are not necessarily evidence of insecurity or poor parenting; they are common in many children and do not always indicate underlying issues. Option D, tics, refers to sudden, repetitive movements or sounds that can be difficult to control. While some behaviors listed may resemble tics, they are more likely habit disorders based on the context provided in the question. Educationally, it is important for pediatric nurses to be able to differentiate between habit disorders, tics, and other behaviors commonly seen in children to provide appropriate care and support. By understanding the underlying reasons for these behaviors, healthcare providers can offer effective interventions and guidance to help children manage their stress and anxiety in a healthy manner.

Correct Answer: A

Rationale: In pediatric nursing, effective communication with parents is crucial for providing optimal care for children. The correct answer to this question is A) hidden anxiety. When a parent does not appear readily reassured by the diagnosis or treatment plan, it may indicate underlying anxiety that is not overtly expressed. This hidden anxiety can stem from various sources such as fear of the unknown, concerns about their child's well-being, or past traumatic experiences. Option B) mistrust may seem like a plausible choice, but in this context, the lack of reassurance is more likely due to the parent's own internal emotional state rather than a lack of trust in the healthcare provider. Option C) negativism and D) oppositionism are less likely in this scenario as they suggest a more overtly negative or oppositional attitude from the parent, which is not necessarily implied by the lack of reassurance alone. Educationally, understanding the nuances of parental reactions and emotions is crucial for pediatric nurses. By recognizing signs of hidden anxiety, nurses can provide additional support, empathy, and information to address parents' concerns effectively. This can help build trust, improve communication, and ultimately enhance the overall care experience for both the child and the parent.