The MOST consistent statement of structural MRI brain findings of autistic spectrum disorders (ASD) is

Correct Answer: B

Rationale: The correct answer is B) increase brain size. In pediatric patients with autistic spectrum disorders (ASD), structural MRI brain findings often show an increased brain size, particularly in early childhood. This phenomenon is known as macrocephaly and is one of the consistent features seen in individuals with ASD. This structural abnormality is thought to be related to abnormal brain development and enlargement of certain brain regions. Option A) diffuse brain atrophy is incorrect because ASD is not typically associated with widespread brain shrinkage. Option C) focal fibrosis and option D) white matter degenerative changes are also incorrect as they are not commonly observed structural MRI findings in individuals with ASD. Educationally, understanding the structural MRI findings associated with ASD is crucial for healthcare professionals, especially pediatric clinical nurse specialists, who work with children diagnosed with ASD. Recognizing these patterns can aid in early diagnosis, treatment planning, and providing appropriate care and support to children and their families. Keeping abreast of the latest research findings in this area is essential for providing evidence-based care to children with ASD.

Correct Answer: B

Rationale: In this question, the correct answer is B) apnea, which is a common neonatal respiratory problem associated with premature infants. Apnea refers to a pause in breathing that lasts for 20 seconds or longer, which can be particularly prevalent in premature newborns due to their immature respiratory control centers. Option A) bronchopulmonary dysplasia is a chronic lung condition that primarily affects premature infants who have received prolonged mechanical ventilation and oxygen therapy, leading to lung damage over time. While it is a respiratory issue in premature infants, it is not as common as apnea. Option C) congenital pneumonia refers to an infection in the lungs that a newborn acquires before birth or during delivery. While it is a respiratory problem, it is not specific to premature infants and is not as common as apnea in this population. Option D) pneumothorax is the presence of air in the pleural space around the lungs, which can cause lung collapse and respiratory distress. While pneumothorax can occur in premature infants, it is not as common as apnea as a neonatal respiratory problem associated with prematurity. Educationally, understanding common neonatal respiratory problems in premature infants is crucial for pediatric clinical nurse specialists to provide appropriate care and interventions. Recognizing signs of apnea and knowing how to respond effectively can be life-saving for these vulnerable patients. This knowledge helps in improving outcomes and reducing complications in neonatal care settings.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) cerebral palsy. Early postnatal exposure to dexamethasone in very low birth weight (VLBW) infants is associated with various adverse effects, such as metabolic derangements, poor growth, and an increased risk for sepsis. Dexamethasone is a corticosteroid that, when administered in the early postnatal period, can lead to metabolic issues like hyperglycemia and hypertension. It can also negatively impact growth by affecting weight gain and bone mineralization in preterm infants. Additionally, dexamethasone can suppress the immune system, putting infants at a higher risk for sepsis. Cerebral palsy is a neurodevelopmental disorder primarily caused by brain injury or abnormal brain development, not by dexamethasone exposure. Understanding the potential complications of dexamethasone in VLBW infants is crucial for pediatric clinical nurse specialists to provide safe and effective care. This knowledge helps in recognizing and managing the adverse effects of medications in vulnerable populations, ultimately improving patient outcomes and quality of care.

Correct Answer: D

Rationale: In the treatment of metabolic acidosis in Respiratory Distress Syndrome (RDS), alkali therapy is often utilized to correct the acid-base imbalance. The correct answer, option D, "hyperkalemia," is the exception among the listed outcomes. Alkali therapy, which typically involves the administration of sodium bicarbonate, can lead to an increased risk of hyperkalemia due to the movement of potassium out of cells in exchange for hydrogen ions, potentially elevating serum potassium levels. Option A, "skin slough from infiltration," is incorrect as alkali therapy can indeed cause skin slough from infiltration due to its alkaline nature, which can lead to tissue damage upon extravasation. Option B, "increased serum osmolarity," is incorrect. Alkali therapy can actually decrease serum osmolarity as it helps in correcting the acidosis, which can contribute to decreased serum osmolarity. Option C, "hypernatremia," is also incorrect. Alkali therapy does not typically result in hypernatremia; in fact, it can help in the correction of acidosis without affecting sodium levels significantly. Educationally, understanding the potential complications and effects of alkali therapy in the context of treating metabolic acidosis in RDS is crucial for pediatric clinical nurse specialists. This knowledge helps in providing safe and effective care to pediatric patients with RDS and metabolic imbalances, ensuring that treatment interventions are monitored closely to prevent adverse outcomes such as hyperkalemia.

Correct Answer: C

Rationale: In neonatal necrotizing enterocolitis (NEC), the correct answer is C) in most situations, a pathogen is identified. This is the exception among the options as NEC is typically considered a polymicrobial process involving various bacteria, but a specific pathogen is not always identified. Option A is incorrect because in fatal cases, gangrene from NEC can indeed extend from the stomach to the rectum due to the severe nature of the disease. Option B is incorrect as prematurity is a well-established major risk factor for NEC, making this statement true. Option D is also incorrect as NEC is actually less common in infants fed human milk, which has protective properties against NEC compared to formula feeding. From an educational perspective, understanding the nuances of NEC pathology is crucial for pediatric clinical nurse specialists to provide optimal care for neonates at risk. Knowing the risk factors, clinical presentations, and potential complications of NEC is essential to ensure early recognition and appropriate management to improve outcomes for these vulnerable patients.