The most common cause of neonatal cholestasis is

Correct Answer: D

Rationale: In pediatric nursing, understanding neonatal cholestasis is crucial for providing effective care to newborns. The correct answer is D) Biliary atresia. Biliary atresia is the most common cause of neonatal cholestasis, characterized by the obstruction or absence of the bile ducts, leading to bile flow impairment and liver damage. Early identification and intervention are vital to prevent irreversible liver damage and improve outcomes. Option A) Idiopathic neonatal hepatitis is a broad term for liver inflammation of unknown cause, less common than biliary atresia in causing neonatal cholestasis. Option B) ABO incompatibility typically presents with hemolytic jaundice due to mismatched blood types between mother and baby, not causing cholestasis. Option C) Progressive familial intrahepatic cholestasis is a genetic disorder causing impaired bile formation but is less common than biliary atresia in neonates. Educationally, this question highlights the importance of recognizing biliary atresia as a primary cause of neonatal cholestasis, emphasizing the need for prompt diagnosis and appropriate management to prevent complications. It reinforces the significance of differential diagnosis skills in pediatric nursing to ensure timely and accurate treatment for neonatal conditions.

Correct Answer: A

Rationale: The correct answer is A) Increased heart size. In pediatric patients with congestive heart failure (CHF), an increased heart size is often the earliest sign visible on a chest X-ray. This is due to the heart working harder to pump blood effectively, leading to myocardial hypertrophy and enlargement. Option B) Pulmonary edema typically manifests as a dense, fluffy appearance in the lungs due to fluid accumulation, not specifically related to CHF in the context of this question. Option C) Pulmonary vascular congestion would show as prominent pulmonary vessels on X-ray, which can be seen in various conditions, not just CHF. Option D) Pleural effusion presents as fluid in the pleural space surrounding the lungs, which can occur in CHF but is not the earliest sign typically visible on a chest X-ray. In an educational context, understanding the early signs of CHF in pediatric patients is crucial for prompt diagnosis and intervention to prevent complications. Recognizing an increased heart size on a chest X-ray can prompt further assessment and management to improve outcomes for children with CHF. It is essential for nurses caring for pediatric patients to be able to identify these early signs and symptoms to provide timely and effective care.

Correct Answer: A

Rationale: The correct answer is A) Respiratory acidosis, uncompensated. In this scenario, the pH is below the normal range (<7.35), indicating acidosis. The PaCO2 is elevated at 80 mm Hg, indicating respiratory acidosis as it is the primary cause of the acid-base imbalance. The HCO3 level is normal, suggesting the body has not fully compensated for the respiratory acidosis. The PaO2 level is low, indicating hypoxemia, which can further exacerbate the acidosis. Option B) Respiratory acidosis, partially compensated is incorrect because the HCO3 level is within normal range, indicating incomplete compensation for the respiratory acidosis. Option C) Metabolic acidosis, partially uncompensated is incorrect because the primary disturbance is respiratory (elevated PaCO2), not metabolic, and the HCO3 level is normal. Option D) Metabolic alkalosis, uncompensated is incorrect as none of the ABG values suggest metabolic alkalosis. Understanding how to interpret ABG values is crucial in pediatric nursing to assess a child's respiratory and metabolic status accurately. Recognizing the underlying acid-base imbalance helps in determining appropriate interventions and treatments to restore balance and improve patient outcomes.

Correct Answer: A

Rationale: In pediatric nursing, understanding the causes of shock is crucial for timely and effective interventions. Obstructive shock occurs when there is a physical obstruction to blood flow, leading to inadequate tissue perfusion. In this context, the correct answer is A) Tension pneumothorax. Tension pneumothorax involves a buildup of air in the pleural space, causing compression of the lung and major vessels, impairing venous return, and leading to obstructive shock. Anaphylaxis (B) is characterized by a systemic allergic reaction, resulting in distributive shock due to vasodilation and increased capillary permeability. Sepsis (C) is a systemic inflammatory response to infection, causing distributive shock through vasodilation and endothelial damage. Hemorrhage (D) leads to hypovolemic shock due to decreased circulating blood volume. Educationally, understanding the specific etiologies of shock in pediatric patients is essential for nurses to recognize early signs, implement appropriate treatments, and prevent complications. This knowledge aids in prioritizing patient care and improving outcomes in emergency situations. By mastering these concepts, nurses can provide safe and effective care to pediatric patients experiencing shock.

Correct Answer: A

Rationale: The correct answer is option A: Fever, new cardiac murmur, splenomegaly. This clinical scenario raises suspicion for bacterial endocarditis in a child because bacterial endocarditis often presents with nonspecific symptoms like fever and can lead to the development of new cardiac murmurs due to valvular damage. Splenomegaly can also be a common finding in bacterial endocarditis due to embolic phenomena affecting the spleen. Option B (Tachypnea, tachycardia, cardiac murmur, sudden onset leg swelling) is less indicative of bacterial endocarditis as sudden onset leg swelling is more commonly associated with conditions like deep vein thrombosis or heart failure. Option C (Positive CRP, skin lesion, hepatomegaly) does not strongly suggest bacterial endocarditis as the presence of skin lesions and hepatomegaly are not specific to this condition. Option D (Positive ASO titre, progressively louder heart murmur, marked hepatomegaly) is more suggestive of acute rheumatic fever rather than bacterial endocarditis due to the positive ASO titre and the association with a progressively louder heart murmur. In an educational context, understanding the clinical manifestations and diagnostic indicators of bacterial endocarditis in children is crucial for timely identification and treatment of this serious condition. This knowledge helps pediatric nurses provide comprehensive care and support to children at risk for or diagnosed with bacterial endocarditis.