What is the best explanation for breath-holding spells?

Correct Answer: A

Rationale: Breath-holding spells in children are a phenomenon characterized by a child involuntarily holding their breath to the point of fainting. The correct answer, A) Manifestation of iron deficiency anemia, is the best explanation for this condition. Iron deficiency anemia can lead to decreased oxygen-carrying capacity in the blood, which can trigger these spells as a compensatory mechanism to increase oxygen levels. Option B) Type of seizure is incorrect because breath-holding spells are not a form of seizure activity. Option C) Expressed as a brief tonic movement is inaccurate as breath-holding spells involve a child holding their breath, not tonic movements. Option D) Resolve by age 5 is incorrect as breath-holding spells can persist beyond age 5, though they often improve with age. In an educational context, understanding the underlying cause of breath-holding spells is crucial for pediatric nurses. Recognizing that iron deficiency anemia can be a trigger empowers nurses to provide appropriate interventions such as iron supplementation and education on dietary modifications. This knowledge enhances the nurse's ability to support both the child and their family in managing and potentially preventing further episodes of breath-holding spells.

Correct Answer: D

Rationale: In this question, the correct answer is D) fluoxetine tricyclic antidepressants. Fluoxetine belongs to the class of selective serotonin reuptake inhibitors (SSRIs), not tricyclic antidepressants. Tricyclic antidepressants include medications like amitriptyline, imipramine, and nortriptyline, which have a different mechanism of action compared to SSRIs like fluoxetine. Option A, methylphenidate as a stimulant, is correct as methylphenidate is commonly used to treat attention deficit hyperactivity disorder (ADHD) by increasing dopamine and norepinephrine levels in the brain. Option B, atomoxetine as a serotonin-norepinephrine reuptake inhibitor, is also correct as atomoxetine is a non-stimulant medication used to treat ADHD by affecting the levels of norepinephrine in the brain. Option C, escitalopram as a selective serotonin reuptake inhibitor, is correct as escitalopram is an SSRI commonly used to treat depression and anxiety disorders by increasing serotonin levels in the brain. Understanding the pharmacological groups of medications is crucial for pediatric nurses to safely administer and monitor drug therapy in pediatric patients. It is essential for nurses to be able to differentiate between different drug classes to ensure appropriate treatment and minimize potential adverse effects. Knowledge of pharmacology helps nurses make informed clinical decisions and provide optimal care to pediatric patients.

Correct Answer: D

Rationale: Separation anxiety disorder is a common mental health disorder in children characterized by excessive anxiety when separated from primary caregivers. The correct answer, "D) not reported in children above 8 years of age," is right because separation anxiety disorder can persist beyond childhood into adolescence and even adulthood. This disorder is not limited by age but can vary in intensity and presentation throughout an individual's life. Option A, "not manifested below 3 years of age," is incorrect because separation anxiety disorder can indeed manifest in children younger than 3 years old. It is developmentally appropriate for infants and toddlers to experience separation anxiety. However, when this anxiety becomes excessive and persistent, it may indicate a disorder. Option B, "common up to 5% of children," is incorrect as well. Separation anxiety disorder is one of the most common childhood anxiety disorders, affecting around 4-5% of children. Therefore, this option is actually consistent with the prevalence rates of the disorder. Option C, "girls are more affected than boys," is also incorrect. While there may be a slight gender difference in prevalence rates, with girls being slightly more affected in some studies, the overall difference is not substantial enough to be considered a defining characteristic of the disorder. In an educational context, understanding the characteristics and age range of separation anxiety disorder is crucial for pediatric nurses. By recognizing the typical onset, prevalence, gender distribution, and age range of the disorder, nurses can effectively assess, diagnose, and intervene to support children and families experiencing separation anxiety. It is important for nurses to be aware that this disorder can persist into older age groups and not dismiss symptoms based on age alone.

Correct Answer: C

Rationale: In diagnosing autistic spectrum disorder (ASD), language assessment plays a crucial role. Option C, "absent single words by 16 months," is the exception among the given choices that should not raise concern regarding language development and indicate ASD. By 16 months, it is considered within the typical range for a child to not yet have single words, and it is not necessarily indicative of ASD at this age. Options A, B, and D are indicators that may raise concerns about language development and suggest ASD. Absent babbling by 6 months (option A) may indicate a potential issue with early communication skills. Absent gestures by 12 months (option B) is another early red flag for ASD as gestures are a significant part of pre-verbal communication. Absent 2-word purposeful phrases by 24 months (option D) is also a concerning sign, as by this age, children typically begin to combine words to form simple phrases. In an educational context, understanding these developmental milestones and red flags is vital for healthcare professionals working with children, especially pediatric nurses. Recognizing these signs early can lead to timely interventions and support for children with ASD, highlighting the importance of early screening and assessment in pediatric care.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) congenital anomalies. Neonatal mortality refers to the death of a newborn within the first 28 days of life. Congenital anomalies, which are present at birth, are a major cause of neonatal mortality in full-term newborns. These anomalies can affect various organs and systems in the body, leading to life-threatening conditions. Option A) respiratory distress syndrome (RDS) is more commonly seen in premature infants due to immature lungs that lack surfactant. While RDS can be a significant cause of morbidity and mortality in preterm infants, it is less common in full-term newborns. Option B) necrotizing enterocolitis (NEC) is a gastrointestinal emergency that primarily affects premature infants. Full-term newborns are less likely to develop NEC compared to preterm infants. Option C) bronchopulmonary dysplasia (BPD) is a chronic lung disease that primarily affects premature infants who require mechanical ventilation and oxygen therapy. Full-term newborns are not as predisposed to developing BPD as preterm infants. Educationally, understanding the major causes of neonatal mortality is crucial for pediatric nurses to provide optimal care and support to newborns and their families. Recognizing the specific risk factors associated with full-term newborns can help nurses anticipate and address potential complications early, ultimately improving outcomes for these vulnerable patients.