The nurse is interviewing the father of 10-month-old Megan. She is playing on the floor when she notices an electric outlet and reaches up to touch it. Her father says no firmly and removes her from near the outlet. The nurse should use this opportunity to teach the father that Megan:

Correct Answer: A

Rationale: The correct answer is A) is old enough to understand the word no. At 10 months old, infants like Megan are beginning to develop object permanence and basic understanding of cause and effect. They can start to associate actions with consequences, such as being told "no" in a firm tone. This age is a critical period for setting boundaries and teaching safety measures. By using simple language and consistent reinforcement, Megan can learn that certain behaviors are off-limits, like touching electrical outlets. Option B) is too young to understand the word no is incorrect because infants at 10 months old are capable of grasping simple commands and starting to comprehend restrictions. Option C) should already know that electric outlets are dangerous is incorrect as infants lack the cognitive ability to understand danger without explicit teaching. Option D) will learn safety issues better if she is spanked is not appropriate as physical punishment is not effective in teaching safety or promoting positive behavior in children. In an educational context, it is vital for nurses to provide parents with age-appropriate guidance on child development and safety practices. By explaining the cognitive abilities of infants and effective disciplinary strategies, nurses can empower parents to create a safe environment and foster healthy development in their children.

Correct Answer: D

Rationale: The correct answer is D) 8-12 years for the mean age range of breast bud appearance (thelarche) in females. This age range aligns with the typical onset of breast development in girls during puberty. It is important to understand the normal variations in the timing of pubertal milestones to monitor for any deviations that may indicate underlying health concerns. Option A) 5-9 years is too early for the average age of thelarche in females. Girls typically experience breast development closer to the onset of puberty around ages 8-12 years. Option B) 6-10 years is also too early for the mean age range of thelarche. While some girls may start developing breasts around age 6, it is not the average age for this pubertal milestone. Option C) 7-11 years is closer to the correct range, but it still underestimates the typical age range for breast bud appearance in females. Puberty usually begins around 8-12 years of age, which is when breast development commonly starts. Understanding the normal progression of puberty milestones in pediatric nursing is crucial for assessing growth and development, identifying potential health issues, and providing appropriate support and education to patients and their families. By knowing the average age range for thelarche, nurses can offer anticipatory guidance and address any concerns related to puberty in young girls effectively.

Correct Answer: B

Rationale: The correct answer is B) amphetamine. The presentation described aligns with amphetamine toxicity symptoms, including delusions, paranoia, tachycardia, hypertension, hyperpyrexia, diaphoresis, piloerection, mydriasis, hyperreflexia, seizures, hypotension, and dysrhythmia. Understanding the effects of amphetamines is crucial in pediatric nursing as they are increasingly misused by adolescents for various reasons, leading to potentially life-threatening situations. Option A) antidepressant agents typically do not cause the array of symptoms described. Barbiturates (C) usually present with respiratory depression, hypotension, and CNS depression, not the hyperstimulation seen in the case. Benzodiazepines (D) would manifest with CNS depression, sedation, and respiratory depression, contrasting the symptoms presented. Educationally, this question reinforces the importance of recognizing drug toxicity in adolescents, highlighting the need for vigilance in assessment and the critical role of pediatric nurses in identifying and managing such cases promptly to prevent adverse outcomes. Understanding these distinctions is vital for providing safe and effective care to pediatric patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) heart failure. Rapid and deep breathing without other signs of respiratory distress is known as Kussmaul breathing and is often seen in conditions like diabetic ketoacidosis (option A) and renal tubular acidosis (option B) due to metabolic acidosis. Additionally, CNS stimulants (option D) can also lead to increased respiratory rate. Heart failure, however, typically presents with respiratory distress due to pulmonary congestion and edema, leading to symptoms such as shortness of breath, crackles in the lungs, and possibly cyanosis. Therefore, in a case of rapid and deep breathing without these typical signs of respiratory distress, heart failure is less likely to be the cause. In an educational context, understanding the differentiating signs and symptoms of various pediatric conditions is crucial for accurate clinical assessment and intervention. By recognizing the unique presentations of different pathologies, healthcare providers can make timely and appropriate decisions in the care of pediatric patients. This knowledge helps in providing safe and effective care tailored to the specific needs of each child.

Correct Answer: C

Rationale: In pediatric nursing, understanding the timeline of brain damage post-drowning is crucial for providing effective care. The correct answer is C) 30 minutes. After a drowning incident, brain damage can begin to occur as early as 4-6 minutes after the brain is deprived of oxygen. By the 30-minute mark, significant brain damage can already manifest, highlighting the critical importance of timely intervention and resuscitation efforts. Option A) 5 minutes is too early for significant brain damage to occur, though immediate action is still necessary to prevent complications. Option B) 15 minutes is also within the window where brain damage can start, but it may not capture the full extent of potential damage that can occur by 30 minutes. Option D) 60 minutes is too long, as significant brain damage would likely have already occurred by this time, emphasizing the need for rapid response and intervention. Educationally, this question underscores the urgency of recognizing and responding to drowning incidents promptly. It reinforces the importance of quick assessment, initiation of appropriate interventions, and the critical role of pediatric nurses in managing such emergencies to prevent irreversible brain damage in pediatric patients. By understanding this timeline, nurses can be better prepared to act decisively in these high-stakes situations.