The serum total bilirubin of the patient in Question is mg/dL with a direct of mg/dL The hematocrit is %, the reticulocyte count is 5, and the smear reveals poikilocytosis and anisocytosis The Coombs test result is negative The next step in the management of the child's condition is

Correct Answer: C

Rationale: In this scenario, the correct next step in the management of the child's condition is to start phototherapy (Option C). This is because the patient is presenting with elevated total bilirubin levels, indicative of hyperbilirubinemia, which can lead to complications like kernicterus if not promptly addressed. Phototherapy is the initial treatment for neonatal jaundice as it helps convert bilirubin into a form that can be easily excreted by the baby's body. Starting phenobarbital (Option A) is not the appropriate next step in this case because it does not directly address the elevated bilirubin levels. Performing an exchange transfusion (Option B) is a more invasive procedure that is typically reserved for severe cases of hyperbilirubinemia or when phototherapy fails. Stopping breast-feeding (Option D) is not necessary unless there are other specific reasons related to the mother's diet or medications that may be exacerbating the condition. Educationally, understanding the management of neonatal jaundice is crucial for pediatric nurses as it is a common condition seen in newborns. Recognizing the appropriate interventions based on the clinical presentation and lab results is essential to prevent complications and ensure optimal outcomes for the infant. Following evidence-based guidelines and protocols for the management of hyperbilirubinemia is key to providing safe and effective care for neonates.

Correct Answer: B

Rationale: In dealing with a 2-year-old girl exhibiting thumb-sucking behavior, the best response is to choose option B) Ignore the behavior. This is the correct answer because thumb-sucking is a common self-soothing behavior in young children and typically resolves on its own without intervention. Ignoring the behavior helps prevent giving it unnecessary attention or reinforcing it as a means of seeking attention. It is important to understand that most children outgrow thumb-sucking naturally as they mature and develop other coping mechanisms. Option A) Reassurance to the mother may not be the best response as it does not address the behavior directly and may inadvertently make the mother more anxious about the behavior. Option C) Using bitter ointments is not recommended for young children as it can be unpleasant, and there is no need for negative reinforcement in this situation. Option D) Encouraging resolution may put unnecessary pressure on the child and could potentially cause more anxiety around the behavior. In an educational context, understanding normal developmental behaviors in children is crucial for pediatric nurses. By choosing the appropriate response to behaviors like thumb-sucking, nurses can support healthy development and provide guidance to parents without unnecessary intervention. It is important to educate parents about typical behaviors and when intervention may be needed, promoting a holistic approach to pediatric care.

Correct Answer: A

Rationale: In this question about truancy in pediatric nursing practice, the correct answer is A) It is normal behavior in young children. Truancy is defined as the intentional, unjustified, or unauthorized absence from compulsory education. Young children typically do not have the autonomy or means to skip school on their own, so truancy is not considered normal behavior in this age group. Option B) It represents disorganization within the home is incorrect because while truancy can be a symptom of family issues, it is not always indicative of disorganization within the home. Truancy can have various causes, including social, psychological, or academic factors. Option C) It may reflect underlying child abuse is incorrect because while truancy can be associated with child abuse in some cases, it is not a definitive indicator of abuse. Child abuse can manifest in various ways, and truancy is just one potential sign among many. Option D) Adolescents may be at risk of substance abuse is incorrect because while truancy can be a risk factor for substance abuse in adolescents, it is not the only risk factor. There are multiple factors that can contribute to substance abuse in this age group, including peer pressure, mental health issues, and family dynamics. In an educational context, understanding the reasons behind truancy is crucial for pediatric nurses to provide holistic care to their patients. By recognizing the underlying causes of truancy, nurses can intervene early, collaborate with other professionals, and support children and families in addressing the root issues. This knowledge helps nurses promote the health and well-being of children and adolescents in their care.

Correct Answer: C

Rationale: In this scenario, the most appropriate next action for a 24-month-old child diagnosed with Autism Spectrum Disorder (ASD) is to conduct a lead level test, which is option C. Lead exposure can have harmful effects on a child's development, including behavioral issues that can overlap with symptoms of ASD. Therefore, it is crucial to rule out lead exposure as a potential contributing factor to the child's presentation. Option A, physical examination, may not directly address the underlying cause of the child's symptoms related to ASD. Option B, hearing tests, are important but may not be the priority in this case unless there are specific concerns related to hearing. Option D, Woods lamp, is used to assess certain skin conditions and is not relevant to the child's diagnosis of ASD. In an educational context, understanding the rationale behind the choice of diagnostic tests is crucial for pediatric nurses. It helps in developing critical thinking skills and ensures appropriate and evidence-based care for pediatric patients, especially those with developmental disorders like ASD. By prioritizing the lead level test in this case, nurses can contribute to a comprehensive assessment and management plan for children with ASD.

Correct Answer: D

Rationale: In pediatric nursing, understanding stereotypic movements is crucial for assessing and caring for children with developmental or neurological conditions. The correct answer is D) head banging because it is a recognized stereotypic movement, commonly seen in conditions like autism spectrum disorder. Head banging serves as a self-soothing or self-stimulatory behavior. Option A) hand shaking is a recognized stereotypic movement seen in conditions like cerebral palsy. Option B) eye blinking is a common stereotypic movement observed in individuals with Tourette syndrome. Option C) body rocking is another recognized stereotypic movement often seen in children with autism spectrum disorder or sensory processing disorders. Educationally, knowing these stereotypic movements helps nurses in early recognition of potential developmental or neurological issues in children. Recognizing and understanding these movements allows for appropriate interventions and support to be provided to improve the child's quality of life and overall well-being.