The most common causative organism of afebrile pneumonia of infancy is:

Correct Answer: D

Rationale: The correct answer is D) Chlamydia trachomatis. In pediatric nursing, it is crucial to understand the common causative organisms for different conditions to provide accurate care. Afebrile pneumonia in infancy is often caused by Chlamydia trachomatis, a bacteria commonly associated with respiratory infections in newborns. Staphylococcus (option A) is more commonly known for causing skin infections rather than afebrile pneumonia in infants. Hemophilus influenza (option B) is a common cause of respiratory infections in children but is not the most common causative organism for afebrile pneumonia in infancy. Streptococcus pneumoniae (option C) is a leading cause of bacterial pneumonia in children but is not typically associated with afebrile pneumonia in infants. Educationally, understanding the specific pathogens associated with different conditions helps nurses and healthcare providers make accurate clinical decisions, prescribe appropriate treatments, and provide targeted care. It also emphasizes the importance of early detection and appropriate management to prevent complications in pediatric patients.

Correct Answer: B

Rationale: The correct answer is B) Bacterial Meningitis. In a 5-year-old girl with altered mental status and cerebrospinal fluid (CSF) findings of high white blood cells (WBCs) with predominantly neutrophils, low sugar, and high protein, the most likely diagnosis is bacterial meningitis. Bacterial meningitis is characterized by a high neutrophil count in the CSF, low glucose levels, and high protein levels. This is due to the acute inflammatory response caused by bacterial pathogens. The altered mental status is also a common symptom seen in bacterial meningitis due to the infection affecting the brain. Option A) Normal is incorrect as the clinical presentation and CSF findings are indicative of an abnormal, inflammatory process. Option C) Viral encephalitis typically presents with lymphocytic predominance in the CSF, as well as other specific clinical findings such as seizures and focal neurological deficits, which are not mentioned in the question stem. Option D) TB Meningitis would show a lymphocytic predominance in the CSF, and TB Meningitis is less common in this age group compared to bacterial meningitis. In an educational context, understanding the typical CSF findings and clinical presentations of different types of meningitis is crucial for pediatric nurses to provide timely and appropriate care. Recognizing the signs and symptoms of bacterial meningitis in children is vital as it is a medical emergency requiring prompt treatment to prevent serious complications.

Correct Answer: C

Rationale: In hemophilia A, which is a genetic disorder caused by deficiency of clotting factor VIII, the correct answer is C) Prolonged APTT (activated partial thromboplastin time). This is because hemophilia A specifically affects the intrinsic pathway of the coagulation cascade, leading to a prolonged APTT due to the deficiency of factor VIII. Option A) Prolonged bleeding time is incorrect because hemophilia A primarily affects clotting factors, not platelet function, which is assessed by bleeding time. Option B) Prolonged prothrombin time is incorrect because prothrombin time primarily evaluates the extrinsic pathway of the coagulation cascade, which is not primarily affected in hemophilia A. Option D) Prolonged thrombin time is incorrect because thrombin time evaluates the conversion of fibrinogen to fibrin, which is not directly impacted by factor VIII deficiency in hemophilia A. Educationally, understanding the specific clotting factors involved in hemophilia A and how they affect different parts of the coagulation cascade is crucial for accurate diagnosis and management of patients with this condition. Nurses caring for pediatric patients with hemophilia A need to recognize the importance of monitoring APTT levels and administering factor replacement therapy to prevent and treat bleeding episodes effectively.

Correct Answer: D

Rationale: The correct answer for the question regarding the appearance of skin elevated temperature in roseola infantum infection being once the fever drops (Option D) is based on the characteristic progression of this viral illness. Roseola infantum, also known as sixth disease, typically presents with high fever for several days followed by the sudden resolution of fever and the appearance of a raised, maculopapular rash. Option A (1st day of fever) is incorrect because roseola infantum is characterized by a few days of high fever before the rash appears. Option B (3rd day of fever) is incorrect as the rash typically appears after the fever has subsided. Option C (4th day of fever) is also incorrect as it does not align with the typical progression of this viral infection. In an educational context, understanding the timeline of symptoms in childhood illnesses like roseola infantum is crucial for pediatric nurses. This knowledge helps in accurate assessment, diagnosis, and management of pediatric patients. By recognizing the sequence of events in roseola infantum, healthcare providers can provide appropriate anticipatory guidance to parents and ensure the well-being of the child during the course of the illness.

Correct Answer: B

Rationale: In the case of an infant with marked cyanotic heart defect and decreased pulmonary vascularity, the correct treatment option is Prostaglandin E1 (Option B). Prostaglandin E1 is used to maintain the patency of the ductus arteriosus in such cases, allowing for improved mixing of oxygenated and deoxygenated blood, which can help alleviate cyanosis and improve oxygenation. Epinephrine (Option A) is a medication used in cases of cardiac arrest or severe allergic reactions and would not be the primary treatment for this specific cardiac condition. Dopamine (Option C) is a medication used to support blood pressure and cardiac output in cases of hypotension, which may not directly address the underlying cyanotic heart defect. Digoxin (Option D) is a medication used in some cases of heart failure but is not the first-line treatment for a marked cyanotic heart defect with decreased pulmonary vascularity. In an educational context, understanding the rationale behind the correct treatment is crucial for pediatric nurses caring for infants with complex cardiac conditions. Knowing the appropriate medications and their mechanisms of action can significantly impact patient outcomes and ensure safe and effective care delivery. This knowledge also highlights the importance of thorough assessment, accurate diagnosis, and evidence-based treatment interventions in pediatric nursing practice.