The MOST common physical finding on exam in bronchopulmonary dysplasia (BPD) is:

Correct Answer: B

Rationale: In bronchopulmonary dysplasia (BPD), the most common physical finding on exam is tachypnea (Option B). This is because BPD is a chronic lung disease that primarily affects premature infants who have undergone mechanical ventilation and oxygen therapy. Tachypnea, or rapid breathing, is a hallmark sign of respiratory distress in these patients due to the impaired lung function and structural changes in the airways. Option A, dyspnea, may also be present in BPD, but tachypnea is more characteristic and prevalent in these patients. Dyspnea refers to difficult or labored breathing, which can occur in various respiratory conditions but is not as specific to BPD as tachypnea. Option C, mouth breathing, is not a primary physical finding in BPD. While some infants with respiratory issues may exhibit mouth breathing, it is not as common or specific to BPD as tachypnea. Option D, increased anteroposterior diameter of the chest, is more commonly associated with conditions like chronic obstructive pulmonary disease (COPD) or barrel chest in adults. In BPD, the chest may appear hyperinflated due to air trapping, but this is not typically described as an increased anteroposterior diameter. In an educational context, understanding the key physical findings in BPD is vital for nurses caring for premature infants in the neonatal intensive care unit (NICU). Recognizing tachypnea as a prominent sign of respiratory distress in BPD can help nurses provide timely interventions and support to optimize patient outcomes. This knowledge enhances the quality of care and improves patient safety in managing infants with BPD.

Correct Answer: C

Rationale: In the context of pediatric respiratory health, monitoring factor V serially is crucial as it serves as a sensitive index of synthetic liver function. Factor V is a key clotting factor synthesized by the liver. Children with respiratory issues may face compromised liver function due to various reasons such as medications, infections, or congenital conditions. By measuring factor V levels, healthcare providers can assess the liver's ability to produce this essential clotting factor, which is vital for maintaining hemostasis and preventing bleeding complications. Option A, prothrombin time, and option B, partial thromboplastin time, are both important coagulation tests, but they do not directly assess the synthetic function of the liver like factor V does. These tests primarily evaluate the extrinsic and intrinsic pathways of the coagulation cascade, respectively, and are more indicative of clotting factors' activity rather than their production. Option D, synthetic function, is a broad term that encompasses various aspects of liver function, including the production of clotting factors like factor V. While monitoring synthetic function is essential, specifically measuring factor V provides a more direct and sensitive indicator of the liver's synthetic capacity in the context of coagulation. Understanding the significance of monitoring factor V levels in pediatric patients with respiratory issues is crucial for nurses and healthcare professionals caring for these vulnerable populations. It allows for early detection of potential liver dysfunction, enabling prompt interventions to prevent bleeding complications and improve patient outcomes.

Correct Answer: D

Rationale: The correct answer is D) 100% O2. When a nonrebreather mask with reservoir is used, it can deliver nearly 100% oxygen to the patient. This is essential in cases where a high concentration of oxygen is needed to improve oxygenation rapidly, such as in cases of respiratory distress or hypoxemia. Option A) 60% O2, Option B) 70% O2, and Option C) 80% O2 are incorrect because they do not reflect the capability of a nonrebreather mask with reservoir to provide nearly 100% oxygen. Using these lower concentrations of oxygen may not be sufficient in situations where the patient requires a higher level of oxygenation. In an educational context, understanding the different oxygen delivery systems and their capabilities is crucial for nurses caring for pediatric patients with respiratory issues. Knowing when and how to use each type of mask based on the patient's condition can significantly impact their outcomes. It is important for nurses preparing for the NCLEX exam to have a solid understanding of oxygen delivery systems to provide safe and effective care to pediatric patients with respiratory needs.

Correct Answer: D

Rationale: The correct answer is D) Gastroesophageal reflux. An acute life-threatening event (ALTE) is a sudden, unexpected event that may indicate a serious underlying condition. Gastroesophageal reflux can lead to symptoms such as choking, apnea, and color changes due to aspiration of gastric contents. This can result in a frightening event resembling ALTE. Option A) Breath-holding spells are characterized by a child voluntarily holding their breath, usually in response to a stressor. This is not typically associated with apnea or color changes seen in ALTE. Option B) Intracranial bleeding is a serious condition but is not typically associated with the sudden onset of symptoms like apnea, color changes, or choking seen in ALTE. Option C) Pertussis, also known as whooping cough, can cause prolonged coughing spells but is less likely to present with sudden apnea, color changes, or choking seen in ALTE. Educationally, understanding the distinguishing features of various conditions that can mimic ALTE is crucial for pediatric nurses to provide timely and appropriate interventions. Recognizing the signs and symptoms of gastroesophageal reflux as a potential cause of ALTE is essential for accurate assessment and management of pediatric patients.

Correct Answer: C

Rationale: Rationale: The correct answer is C) Damage to the recurrent laryngeal nerve. Vocal cord paralysis is commonly caused by damage to the recurrent laryngeal nerve, which innervates the muscles responsible for vocal cord movement. Unilateral or bilateral paralysis can result in significant respiratory and phonatory complications. Option A) Arnold-Chiari malformation is a congenital condition involving the brainstem and cerebellum, not directly related to vocal cord paralysis. Option B) Hydrocephalus is an abnormal accumulation of cerebrospinal fluid in the brain, which does not typically lead to vocal cord paralysis. Option D) Stroke can affect various parts of the brain but is not a common cause of vocal cord paralysis. Educationally, understanding the anatomy and function of the recurrent laryngeal nerve is crucial for nurses caring for pediatric patients with respiratory issues. Recognizing the signs and symptoms of vocal cord paralysis and its potential causes can aid in prompt assessment and intervention to prevent respiratory compromise. Nurses must be able to differentiate between various conditions affecting the pediatric airway to provide appropriate care and support.