The main risk factor for developing deep vein thrombosis is:

Correct Answer: A

Rationale: In the context of pediatric cardiovascular nursing, understanding the risk factors for deep vein thrombosis (DVT) is crucial for providing safe and effective care to pediatric patients. The main risk factor for developing DVT is prolonged immobility, making option A the correct answer. Prolonged immobility leads to venous stasis, which can cause blood to pool in the veins, increasing the risk of clot formation. Children who are immobile for extended periods, such as those hospitalized for a cardiac condition or recovering from surgery, are particularly at risk for DVT. Option B, age, is not the main risk factor for DVT in pediatric patients, although advanced age is a risk factor in adults. Option C, obesity, can contribute to venous stasis but is not the primary risk factor in pediatric patients. Option D, family history, while important in some cases, is not the main risk factor for developing DVT in pediatric patients. Educationally, it is important for pediatric cardiovascular nurses to recognize the significance of immobility in the development of DVT in children. Implementing preventive measures such as early mobilization, compression stockings, and anticoagulant therapy when appropriate can help reduce the risk of DVT in this vulnerable population. Regular assessment for signs and symptoms of DVT is also essential for early detection and intervention.

Correct Answer: B

Rationale: In pediatric cardiovascular nursing, assessing gestational age accurately is crucial for providing appropriate care. The Dubowitz criteria are commonly used for this purpose, including various physical and neuromuscular assessments. In this case, the correct answer is B) Breast tissue. The development of breast tissue in newborns is one of the key indicators used in the Dubowitz criteria to assess gestational age. Premature infants typically have less developed breast tissue compared to full-term infants. A) Skin color is not a specific criterion in the Dubowitz assessment for gestational age. While skin color can provide some general information, it is not as reliable or specific as other criteria. C) Popliteal angle is not a part of the Dubowitz criteria. The popliteal angle is typically used to assess neuromuscular development in infants but is not specific to gestational age assessment. D) Moro reflex is an important neonatal reflex but is not included in the Dubowitz criteria for assessing gestational age. The Moro reflex is more related to neurological maturity rather than gestational age determination. Educationally, understanding the Dubowitz criteria and its components is essential for pediatric nurses to accurately assess newborns and provide appropriate care based on their gestational age. By knowing the specific criteria such as breast tissue development, nurses can better identify and care for infants with varying degrees of prematurity.

Correct Answer: A

Rationale: The correct answer is A) Is more likely in anti-thrombin III deficiency. Rationale: Anti-thrombin III is a natural anticoagulant that inhibits blood clot formation. When deficient, there is an increased risk of developing blood clots, including pulmonary embolism. Combined oral contraceptive pills contain estrogen and progestin, which further increase the risk of thrombosis by promoting clotting factors. Therefore, in a patient with anti-thrombin III deficiency, the risk of developing a pulmonary embolus while on the combined pill is significantly higher. B) Is more likely in protein C deficiency: Protein C is also an anticoagulant protein, but its deficiency typically leads to an increased risk of venous thrombosis rather than pulmonary embolism specifically in the context of oral contraceptive use. C) Is an absolute contraindication to the combined pill: While a history of pulmonary embolism would be a contraindication to estrogen-containing contraceptives, an acute event like a pulmonary embolus occurring while on the pill does not necessarily make it an absolute contraindication. D) Is an increased risk in smokers: Smoking is a well-known risk factor for cardiovascular diseases, including venous thromboembolism. However, the primary factor in this scenario is the underlying anti-thrombin III deficiency rather than smoking status alone. Educational Context: Understanding the interaction between pharmacological agents like oral contraceptives and underlying conditions such as coagulation disorders is crucial in pediatric cardiovascular nursing. This knowledge helps in assessing risks, making informed decisions about treatment options, and providing safe and effective care to pediatric patients with complex medical needs.

Correct Answer: B

Rationale: In the management of intussusception in pediatric patients, the correct treatment option is B) Air enema. This procedure involves using air pressure to push the telescoped bowel segments back into their normal position. The rationale behind why air enema is the right choice lies in its effectiveness as a non-invasive method that can often successfully resolve intussusception without the need for surgery. It is considered a first-line treatment due to its high success rates and lower risk of complications compared to surgical intervention. Contrast enema (option A) is another non-surgical option, but it involves using a contrast agent along with air or liquid to aid in diagnosis and treatment. Water enema (option C) is not typically used in the management of intussusception due to its lower success rates compared to air enema. Open surgery (option D) is usually reserved for cases where non-invasive methods have failed or in the presence of complications like bowel perforation. In an educational context, understanding the appropriate treatment options for intussusception is crucial for pediatric nurses and healthcare providers working with pediatric patients. Knowing when to recommend non-invasive methods like air or contrast enema versus surgical intervention can significantly impact patient outcomes and reduce the need for more invasive procedures. It is essential for healthcare professionals to stay updated on current guidelines and best practices in pediatric cardiovascular nursing to provide optimal care for their patients.

Correct Answer: C

Rationale: In pediatric nursing, recognizing red flags for conditions like cerebral palsy is crucial for early intervention and management. In this case, the correct answer is C) Hand dominance. At 9 months, hand dominance is not typically established in infants, and its presence can indicate a compensatory mechanism for motor deficits seen in cerebral palsy. This is a key feature that should raise suspicion for the condition. Option A) Presence of Moro reflex is incorrect because the Moro reflex is a normal primitive reflex seen in infants up to around 6 months of age and its presence at 9 months is not indicative of cerebral palsy. Option B) Abductor spasm is not a typical feature of cerebral palsy in infants at 9 months. Option D) Grasp reflex is a normal developmental reflex in infants and its presence alone does not specifically point towards cerebral palsy. Educationally, understanding the significance of developmental milestones and abnormal findings is essential for pediatric healthcare providers. Recognizing subtle signs like hand dominance can lead to early referrals for further evaluation and intervention, potentially improving outcomes for children with cerebral palsy. This question highlights the importance of keen observation and knowledge of developmental norms in pediatric nursing practice.