The pediatric nurse, who cares for a 12-year-old patient with septic shock, perceives a potential complication of fluid resuscitation on noting:

Correct Answer: D

Rationale: In this scenario, the correct answer is option D) fluid overload or pulmonary edema. When caring for a pediatric patient with septic shock and administering fluid resuscitation, the nurse should monitor for signs of fluid overload, which can lead to pulmonary edema. This is a potential complication of rapid fluid administration in patients with septic shock. Pulmonary edema presents with symptoms such as respiratory distress, crackles on lung auscultation, and increased work of breathing. Option A) a heart rate of 50 beats/min is not directly related to fluid overload or pulmonary edema. In septic shock, tachycardia is a common finding due to the body's response to infection. Option B) a temperature of 102°F (38.9°C) is indicative of an ongoing infection and inflammatory response, which are expected in septic shock. It is not a specific sign of fluid overload. Option C) reports of leg pain could indicate muscle pain, joint issues, or poor perfusion, but it is not a typical sign of fluid overload or pulmonary edema. Educationally, this question highlights the importance of recognizing potential complications of fluid resuscitation in pediatric patients with septic shock. It emphasizes the need for close monitoring and assessment to detect early signs of fluid overload, which can impact the patient's respiratory status and overall outcome. Nurses must be vigilant in assessing for both desired effects and potential adverse reactions to interventions such as fluid resuscitation in critically ill pediatric patients.

Correct Answer: B

Rationale: In pediatric nursing, understanding child development milestones is crucial for providing effective care. The question pertains to object permanence, a key concept in Piaget's theory of cognitive development. The correct answer is B) 9 months. At this age, infants develop object permanence, realizing that objects continue to exist even when out of sight. They actively search for hidden objects, demonstrating cognitive growth. Option A) 7 months is incorrect as infants at this age do not yet typically exhibit full object permanence. Option C) 11 months is also incorrect as by this age, most children have already developed object permanence skills. Option D) 13 months is incorrect as children typically master object permanence around 8-12 months, so at 13 months, they should have already achieved this milestone. Educationally, understanding developmental milestones helps nurses assess children's growth, plan interventions, and educate caregivers about age-appropriate behaviors. This knowledge is essential for providing holistic care that considers not only physical but also cognitive and emotional development in pediatric patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) behavioral insomnia of childhood. This condition is characterized by difficulty falling asleep and/or staying asleep. In the case of the 4-year-old boy, his refusal to go to bed and remaining active are indicative of behavioral insomnia. This type of insomnia is often linked to poor sleep habits, parental influence, or learned behavior. Option A) thyrotoxicosis is unlikely in this case as it is a condition involving an overactive thyroid gland, leading to symptoms such as weight loss, heat intolerance, and fatigue, rather than solely difficulty sleeping. Option B) ADHD (Attention-Deficit/Hyperactivity Disorder) can present with hyperactivity and impulsivity, but the primary issue is not related to difficulty falling asleep. Children with ADHD may have sleep problems, but the behavior described is more indicative of behavioral insomnia. Option D) sleep-onset association disorder is a condition where a child associates falling asleep with certain conditions or objects. While this could contribute to difficulty falling asleep, the scenario described is more aligned with behavioral insomnia where the child actively resists going to bed. Educationally, understanding common pediatric sleep disorders is crucial for healthcare providers working with children and families. Recognizing the signs and symptoms of different disorders helps in accurate diagnosis and appropriate intervention. Behavioral interventions and sleep hygiene practices are key in managing behavioral insomnia in children, emphasizing the importance of establishing healthy bedtime routines.

Correct Answer: D

Rationale: In this question, the correct answer is option D) nightmare. The rationale behind this is that nightmares are not considered parasomniac disorders. Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. Option A) sleepwalking, Option B) sleepterror, and Option C) confusional arousal are all examples of parasomniac disorders. Sleepwalking involves walking or performing other complex behaviors while asleep. Sleepterrors are episodes of intense fear, screaming, and flailing while still asleep. Confusional arousal is a sleep disorder characterized by partial awakening and appearing confused or disoriented. It is important for pediatric nurses to understand these distinctions in order to accurately assess and manage pediatric patients with sleep disorders. By recognizing the different types of parasomnias, nurses can provide appropriate education to families, implement safety measures, and collaborate with other healthcare professionals to develop comprehensive care plans for children experiencing these sleep disturbances.

Correct Answer: D

Rationale: In infants, inferences about vision may be made by physical examination of the eye and assessment of personal-social development. The correct answer is D) personal-social. The personal-social domain in infants includes behaviors related to interactions with others, such as eye contact, social smiling, and following faces. By observing an infant's personal-social behaviors, healthcare providers can gain insights into the infant's visual development. Lack of appropriate personal-social behaviors may indicate potential vision problems that require further evaluation. Option A) language, Option B) intelligence, and Option C) gross motor are incorrect because they do not directly correlate with assessing vision in infants. While language, intelligence, and gross motor skills are important aspects of infant development, they do not provide specific insights into vision assessment. Educationally, understanding how to assess vision in infants is crucial for healthcare providers working in pediatric settings. By recognizing the importance of personal-social behaviors in evaluating vision, healthcare professionals can identify potential visual impairments early and initiate appropriate interventions to support optimal visual development in infants.