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 the case of a 12-year-old patient with septic shock, the pediatric nurse should be vigilant for signs of fluid overload or pulmonary edema as potential complications of fluid resuscitation. Septic shock often leads to capillary leak syndrome, causing fluid to shift from the vascular space into the interstitial space, potentially leading to fluid overload. This can manifest as increased work of breathing, crackles in the lungs, and decreased oxygen saturation. Option A, a heart rate of 50 beats/min, is not indicative of fluid overload but rather bradycardia, which can be a sign of impending cardiovascular collapse in septic shock. Option B, a temperature of 102°F (38.9°C), is a common symptom of infection and sepsis, not necessarily a direct result of fluid resuscitation. Option C, reports of leg pain, could indicate compartment syndrome or ischemia but is not directly related to fluid resuscitation complications. Understanding the potential complications of fluid resuscitation in pediatric patients with septic shock is crucial for pediatric nurses to provide timely interventions and prevent further deterioration. Monitoring for signs of fluid overload or pulmonary edema, such as respiratory distress, crackles, and decreased oxygen saturation, is vital for ensuring patient safety and optimal outcomes in this critical condition.

Correct Answer: B

Rationale: The correct answer is B) 9 months. This question pertains to Piaget's theory of cognitive development, specifically the sensorimotor stage. At around 8-12 months, infants develop object permanence, which is the understanding that objects continue to exist even when they are out of sight. When a child searches for a hidden object, it indicates they have achieved object permanence, which typically occurs around 9 months of age. Option A) 7 months is incorrect because infants at this age have not fully developed object permanence. They are still in the earlier stages of sensorimotor development where they may lose interest in hidden objects once they are out of sight. Option C) 11 months and Option D) 13 months are incorrect as they fall outside the typical age range for achieving object permanence. By 11-12 months, most infants have already developed object permanence and would not continue searching for a hidden object once it is out of sight. Understanding Piaget's stages of cognitive development is crucial for pediatric nurses as it helps them assess a child's developmental progress and tailor interventions accordingly. Knowing the age-appropriate behaviors and milestones allows nurses to provide effective care and support for pediatric patients and their families.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) behavioral insomnia of childhood. Behavioral insomnia of childhood is a common sleep problem in young children where they resist going to bed, exhibit difficulty falling asleep, or have trouble staying asleep. The 4-year-old boy's behavior of refusing to go to bed and remaining active aligns with the characteristics of this condition. Understanding this helps identify the root cause of the behavior, allowing for appropriate interventions and management strategies. Option A) Thyrotoxicosis is unlikely in this case as it typically presents with symptoms related to the thyroid gland's overactivity, such as weight loss, increased appetite, and irritability, rather than just bedtime resistance and hyperactivity. Option B) ADHD could present with hyperactivity and difficulty in settling down, but in this case, the behavior is specifically related to bedtime, making behavioral insomnia a more fitting explanation. Option D) Sleep-onset association disorder involves needing a specific condition to fall asleep, such as needing a parent present. While it could lead to bedtime resistance, the boy's behavior of remaining active is more indicative of behavioral insomnia of childhood. Educationally, understanding common pediatric sleep disorders is crucial for healthcare providers working with children and their families. Identifying the underlying causes of sleep disturbances in children is essential for providing appropriate care and support to promote healthy sleep habits and overall well-being. By recognizing the signs and symptoms of different sleep disorders, healthcare professionals can offer tailored interventions to address the specific needs of each child and family.

Correct Answer: D

Rationale: In pediatric nursing, understanding sleep disorders is crucial for providing optimal care to children. The correct answer is D) nightmare because nightmares are not classified as 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. Sleepwalking (A), sleep terror (B), and confusional arousal (C) are all examples of parasomniac disorders. Sleepwalking involves walking or performing other complex behaviors while still asleep. Sleep terror, also known as night terrors, involves intense fear, screaming, and thrashing while still in a state of deep sleep. Confusional arousal is a sleep disorder that involves partial arousal during sleep, leading to confusion and disorientation. Educationally, it is important for nursing students to differentiate between various sleep disorders, including parasomnias, to accurately assess, diagnose, and intervene in pediatric patients' sleep-related issues. Understanding the nuances of each disorder helps in providing appropriate education and support to families dealing with these conditions. This knowledge is essential for promoting healthy sleep patterns and overall well-being in pediatric populations.

Correct Answer: D

Rationale: In infants, inferences about vision may be made by physical examination of the eye and assessment of personal-social behavior. Personal-social skills encompass a wide range of behaviors related to interacting with others and engaging in social activities. Visual impairment can significantly impact a child's ability to develop personal-social skills as they may struggle with making eye contact, recognizing facial expressions, and engaging with their environment. Option A, language, is not directly related to assessing vision in infants. While vision plays a crucial role in language development, the assessment of language skills does not provide information about the visual acuity of an infant. Option B, intelligence, is also not directly related to assessing vision in infants. Intelligence is a complex construct that involves cognitive abilities, problem-solving skills, and adaptive behaviors. Visual impairment does not necessarily correlate with intelligence. Option C, gross motor skills, are important for assessing physical development in infants but do not provide specific information about their visual abilities. Gross motor skills involve activities like crawling, walking, and running, which are not indicative of visual acuity. Educationally, understanding how to assess vision in infants is crucial for pediatric nurses as it allows for early detection of visual impairments that can impact a child's development. By recognizing the signs of visual impairment early on, healthcare providers can refer infants for further evaluation and intervention to support their visual and overall development.