Urinary tract infection:

Correct Answer: D

Rationale: In the context of pediatric cardiovascular disorders nursing, understanding the impact of urinary tract infections (UTIs) is crucial as they can lead to serious complications. The correct answer, D, "Is associated with constipation," is the most appropriate choice because constipation can contribute to UTIs in children by causing a backup of urine, leading to bacterial overgrowth and infection in the urinary tract. Option A, "Usually leads to vesico-ureteric reflux," is incorrect because while UTIs can sometimes be associated with vesico-ureteric reflux, it is not a universal outcome of UTIs. Option B, "Is more common in boys than girls under a year of age," is incorrect. UTIs are actually more common in girls, especially in the first year of life, due to anatomical differences that make them more susceptible to infections. Option C, "In boys, is most commonly caused by Proteus mirabilis," is also incorrect. While Proteus mirabilis is a common cause of UTIs in boys, it is not the most common pathogen responsible for UTIs in this population. Educationally, it is important for nursing students to recognize the risk factors and common etiologies of UTIs in pediatric patients to provide appropriate care and prevent complications. Understanding the relationship between constipation and UTIs can help nurses implement preventive measures and early interventions to improve patient outcomes.

Correct Answer: A

Rationale: In the context of pediatric cardiovascular disorders, the correct answer is option A) Oxygen saturation in the hand is 80% and in the foot 67% for diagnosing primary pulmonary hypertension of the newborn. This is indicative of a significant difference in oxygen saturation between the upper and lower extremities, known as a "step-up" in oxygen saturation, which is a hallmark sign of this condition. Option B) A tachypnoeic baby with a saturation of 60% is not specifically indicative of primary pulmonary hypertension of the newborn. While low oxygen saturation and tachypnea can be present in this condition, the key differentiator is the discrepancy in saturation between the upper and lower limbs. Option C) A baby with a history of meconium aspiration syndrome having a PaO2 of 4kPa is more suggestive of respiratory distress syndrome due to meconium aspiration rather than primary pulmonary hypertension of the newborn. Option D) A septic baby being hypoxic in 100% oxygen is more likely to have hypoxemia due to sepsis rather than primary pulmonary hypertension of the newborn. In an educational context, understanding the specific clinical presentations and diagnostic criteria for pediatric cardiovascular disorders is crucial for accurate assessment and timely intervention. Recognizing the unique signs and symptoms of conditions like primary pulmonary hypertension of the newborn can lead to prompt diagnosis and appropriate management, improving patient outcomes.

Correct Answer: B

Rationale: In pediatric cardiovascular disorders nursing, understanding the clinical manifestations of hemophilia is crucial for providing safe and effective care to pediatric patients. The correct answer is option B) Intracranial bleeding. Hemophilia is a genetic disorder characterized by a deficiency in clotting factors, leading to prolonged and excessive bleeding. Intracranial bleeding is a severe complication of hemophilia and can be life-threatening, especially in pediatric patients. Option A) Bleeding following neonatal intramuscular injection is not a common clinical manifestation of hemophilia. While individuals with hemophilia may experience bleeding after invasive procedures, it is not specific to neonatal injections. Option C) Gingival bleeding is more commonly associated with conditions like gingivitis or blood clotting disorders like thrombocytopenia, rather than hemophilia specifically. Option D) Menorrhagia, or excessive menstrual bleeding, is not a typical clinical manifestation of hemophilia in pediatric patients. While females with hemophilia may experience menorrhagia, it is not a primary clinical manifestation seen in pediatric patients with hemophilia. Educationally, identifying the clinical manifestations of hemophilia, such as intracranial bleeding, helps nurses and healthcare providers promptly recognize and address complications in pediatric patients with this condition. Understanding these manifestations is essential for early intervention and preventing severe outcomes in pediatric patients with hemophilia.

Correct Answer: B

Rationale: In the context of pediatric cardiovascular disorders nursing, understanding distal renal tubular acidosis (dRTA) is crucial. The correct answer is B) May be primary or secondary. Explanation of why B is correct: Distal renal tubular acidosis can be primary, due to a genetic defect affecting the kidneys' ability to regulate acid-base balance, or secondary, caused by conditions like autoimmune diseases or medications. Recognizing this distinction is essential for appropriate management and treatment. Explanation of why others are wrong: A) Is characterised by hypokalaemia - While hypokalemia can occur in some types of renal tubular acidosis, it is more commonly associated with Type 1 renal tubular acidosis, not specifically distal RTA. C) Presents with growth failure in infancy - Growth failure is more commonly seen in proximal renal tubular acidosis, not distal RTA. D) Urinary pH is usually < 5 - In distal RTA, the urinary pH is typically higher (>5.5) due to impaired acidification of urine in the distal tubules. Educational context: Understanding the nuances of different types of renal tubular acidosis is vital for nursing care, especially in pediatric patients with cardiovascular disorders. Recognizing the specific characteristics of distal RTA can guide appropriate interventions and prevent complications related to acid-base imbalances. Nurses must be able to differentiate between types of RTA to provide safe and effective care for these patients.

Correct Answer: B

Rationale: The correct answer is B) In a twice daily regimen involving Mixtard 30 or Humulin M3, the bedtime reading is an effect of the long-acting component. Rationale: In a twice daily regimen with Mixtard 30 or Humulin M3, the bedtime reading is predominantly influenced by the long-acting component of the insulin mixture. This is because the long-acting insulin component works over an extended period, including during the night, helping to maintain stable blood sugar levels. The short-acting component in these mixtures primarily covers mealtime insulin requirements. Explanation of Incorrect Options: A) Short-acting insulin typically reaches peak action within 1-3 hours, not 4-6 hours. This option is incorrect as it provides inaccurate information about the peak action time of short-acting insulin. C) A bedtime blood sugar level of 10 mmol/l may be acceptable depending on the individual's specific diabetes management plan and target range. It is not universally unacceptable and can vary based on the patient's condition and treatment goals. D) While rotating injection sites is recommended to prevent lipodystrophy and ensure consistent insulin absorption, using the same site for injections does not directly lead to increasing insulin dosage. It may impact insulin absorption but is not a common cause of increasing dosage. Educational Context: Understanding the pharmacokinetics and pharmacodynamics of different insulin types is crucial for nurses caring for pediatric patients with diabetes. By knowing how each component of a mixed insulin regimen works, nurses can effectively manage blood glucose levels and prevent complications. Educating patients and families on insulin administration techniques, regimen specifics, and monitoring parameters is essential for successful diabetes management in pediatric patients.