Thrombocytopenia in refeeding syndrome is mainly a result of

Correct Answer: A

Rationale: In refeeding syndrome, when a malnourished individual undergoes rapid refeeding, there is a shift from fat to carbohydrate metabolism, leading to increased insulin secretion and subsequent intracellular uptake of electrolytes. This shift can result in hypophosphatemia, which is the main cause of thrombocytopenia in refeeding syndrome. Option A, hypophosphatemia, is correct because low serum phosphate levels can lead to impaired platelet function and decreased platelet count, causing thrombocytopenia in refeeding syndrome. Option B, hypokalemia, is incorrect because while electrolyte imbalances like hypokalemia can occur in refeeding syndrome, they are not the primary cause of thrombocytopenia in this condition. Option C, hypomagnesemia, is incorrect as well. Although magnesium deficiency can contribute to cardiac arrhythmias in refeeding syndrome, it is not the main factor leading to thrombocytopenia. Option D, thiamine deficiency, is also incorrect. Thiamine deficiency can result in Wernicke's encephalopathy in malnourished individuals, but it is not directly linked to thrombocytopenia in refeeding syndrome. Understanding the pathophysiology of refeeding syndrome and its impact on electrolyte balance and organ function is crucial for nurses and healthcare providers caring for malnourished pediatric patients. Recognizing the role of hypophosphatemia in thrombocytopenia can guide appropriate monitoring and treatment strategies to prevent complications in these vulnerable populations.

Correct Answer: C

Rationale: The correct answer is C) Adrenogenital syndrome. This condition typically presents in infancy with symptoms such as recurrent vomiting, dehydration, hyponatremia, hyperkalemia, and metabolic acidosis. The electrolyte imbalances seen in the patient (low potassium, high bicarbonate) are indicative of this syndrome, caused by a defect in cortisol biosynthesis leading to increased adrenal androgen production. Option A) Duodenal stenosis typically presents with bilious vomiting and is unlikely in this case as the emesis is nonbilious. Option B) Annular pancreas would present with duodenal obstruction and symptoms of bilious vomiting, which are not seen in this patient. Option D) Galactosemia would present with symptoms related to galactose metabolism such as jaundice, liver dysfunction, and coagulopathy, which are not evident in this case. Educationally, understanding the clinical presentation and key laboratory findings of various pediatric gastrointestinal disorders is crucial for nurses preparing for the NCLEX exam as it helps in accurate diagnosis and management of these conditions in pediatric patients. It also highlights the importance of recognizing electrolyte imbalances and metabolic disturbances in infants to provide timely and appropriate interventions.

Correct Answer: B

Rationale: The correct answer is B) Biliary atresia. Biliary atresia is the most common indication for pediatric liver transplantation. This condition involves the obstruction or absence of the bile ducts that drain bile from the liver, leading to liver damage and failure if left untreated. Option A) Neonatal hepatitis is a broad term for liver inflammation in newborns and is not as common an indication for liver transplantation as biliary atresia. Option C) Metabolic liver disease refers to a group of inherited disorders that affect the liver's ability to function properly. While these conditions can be severe, they are not as prevalent as biliary atresia in necessitating liver transplantation in pediatric patients. Option D) Fulminant hepatic failure is a rapid and severe deterioration of liver function, often requiring urgent medical intervention. While this is a serious condition, biliary atresia remains the most common indication for pediatric liver transplantation. Understanding the most common indications for pediatric liver transplantation is crucial for healthcare providers working in pediatric gastroenterology and transplant services. It highlights the importance of early diagnosis and intervention in conditions like biliary atresia to prevent irreversible liver damage and improve outcomes for young patients.

Correct Answer: A

Rationale: The correct answer is A) orlistat. Orlistat is the only FDA-approved medication for obesity in children under 16 years old. Orlistat works by blocking the absorption of fat in the gastrointestinal tract, leading to weight loss. It is generally well-tolerated and has been shown to be effective in managing obesity in pediatric patients. Option B) phentermine is not FDA-approved for use in children under 16 years old. Phentermine is typically prescribed for short-term weight loss in adults and is not recommended for pediatric use due to potential adverse effects on growth and development. Option C) topiramate is not FDA-approved for pediatric obesity. While it has been used off-label for weight management in some cases, its safety and efficacy in children for this indication have not been well established. Option D) amylin is not an FDA-approved medication for pediatric obesity. Amylin is a hormone involved in regulating blood sugar levels and is not indicated for weight loss in children. In an educational context, it is important for healthcare professionals to be aware of the limited options for pharmacological management of obesity in pediatric patients. Understanding the available medications, their mechanisms of action, and their approved indications can help in making informed decisions when treating children with obesity. Additionally, emphasizing the importance of lifestyle modifications, such as diet and exercise, as first-line interventions is crucial in managing pediatric obesity effectively.

Correct Answer: A

Rationale: The correct answer is A) mental status changes, ocular signs, and ataxia. This classic triad is indicative of Wernicke encephalopathy due to thiamine deficiency. Mental status changes such as confusion and disorientation are often present. Ocular signs include nystagmus or abnormal eye movements. Ataxia, which is a lack of muscle coordination, is also a key feature. Option B) cardiac involvement, peripheral neuritis, and aphonia are not characteristic of Wernicke encephalopathy. Cardiac involvement is more commonly seen in conditions like beriberi. Peripheral neuritis and aphonia are not part of the classic triad. Option C) depression, drowsiness, and poor mental concentration do not encompass the classic triad of Wernicke encephalopathy. While these symptoms may be present in thiamine deficiency, they do not specifically define the triad. Option D) increased intracranial pressure, meningismus, and coma are not part of the classic triad of Wernicke encephalopathy. These symptoms are more indicative of other neurological conditions and not specific to thiamine deficiency. Educationally, understanding the classic triad of Wernicke encephalopathy is crucial for healthcare providers, especially when working with pediatric patients. Recognizing these key clinical manifestations can prompt timely intervention and treatment to prevent potentially severe neurological consequences. It is important for nurses and other healthcare professionals to be able to differentiate between different clinical presentations to provide appropriate care for their patients.