What is the most appropriate intervention for a neonate with suspected necrotizing enterocolitis (NEC)?

Correct Answer: B

Rationale: In the case of a neonate with suspected necrotizing enterocolitis (NEC), the most appropriate intervention is B) Antibiotics and supportive care. NEC is a serious condition characterized by inflammation and tissue death in the intestines, primarily affecting premature infants. Antibiotics are crucial in treating NEC as they help combat the bacterial infection that contributes to the condition. Supportive care, including bowel rest, IV fluids, and monitoring for complications, is essential in managing NEC and supporting the infant's recovery. Option A) Surgical resection of the bowel is a more invasive approach and is typically considered if there are severe complications or if conservative measures fail. It is not the first-line intervention for suspected NEC. Option C) Oxygen therapy may be necessary for some infants with respiratory distress, but it is not the primary intervention for NEC. Oxygen therapy is used to support oxygenation in conditions like respiratory distress syndrome but does not directly treat NEC. Option D) Breast milk feeding is beneficial for infants with NEC as it provides important nutrients and promotes gut health. However, in the case of suspected NEC, the priority is to address the infection and provide supportive care before focusing on feeding. Educationally, understanding the appropriate interventions for neonates with NEC is crucial for nurses caring for this vulnerable population. Recognizing the signs and symptoms of NEC, knowing the appropriate steps in management, and understanding the rationale behind each intervention are essential components of pediatric nursing practice. By prioritizing antibiotics and supportive care in cases of suspected NEC, nurses can help improve outcomes and provide optimal care for these infants.

Correct Answer: A

Rationale: The correct answer is A) "We'll keep him at home until phobia subsides." This statement indicates a lack of understanding of how to address school phobia effectively. By keeping the child at home, the parents are inadvertently reinforcing the avoidance behavior, which can exacerbate the phobia in the long run. Option B) "We'll work with his teachers and counselors at school" is a proactive and appropriate response that involves collaboration with professionals who can provide support and guidance in managing the child's school phobia. Option C) "We'll try to encourage him to talk about his problem" demonstrates a willingness to facilitate open communication with the child, which is a positive step in addressing the underlying issues contributing to the phobia. Option D) "We'll discuss possible solutions with him and his counselor" reflects a collaborative approach involving both the child and the counselor in finding solutions to address the school phobia, which is a constructive and supportive strategy. In an educational context, it is crucial for parents to be equipped with the knowledge and skills to understand and address school phobia effectively. Encouraging open communication, seeking support from school professionals, and avoiding reinforcing avoidance behaviors are key principles in managing school phobia in children. By providing parents with the necessary guidance and information, educators can empower them to support their child's emotional well-being and academic success.

Correct Answer: A

Rationale: In this scenario, the most appropriate action for the community health nurse when noting multiple bruises and burns on the posterior trunk of an 18-month-old child during a home visit is to select option A) Report the child's condition to Protective Services immediately. The correct answer is to report the child's condition to Protective Services immediately because the presence of multiple bruises and burns on the child raises serious concerns about possible child abuse or neglect. As a mandated reporter, the nurse has a legal and ethical obligation to report any suspicions of child maltreatment to the appropriate authorities to ensure the safety and well-being of the child. Option B) scheduling a follow-up visit to check for more bruises is not appropriate in this situation as it delays immediate action to protect the child from potential harm. Option C) notifying the child's physician immediately may not be sufficient to address the suspected abuse or neglect and may not involve the necessary child protection agencies. Option D) doing nothing because this is a normal finding in a toddler is not acceptable as it ignores the signs of potential abuse or neglect. From an educational perspective, this question highlights the importance of recognizing signs of child abuse and neglect in pediatric patients, especially for healthcare professionals working in community settings. It underscores the critical role that healthcare providers play in advocating for vulnerable children and taking appropriate action to ensure their safety. Effective communication and collaboration with child protective services are essential in addressing suspected cases of child maltreatment.

Correct Answer: B

Rationale: The correct answer is B) Fear of body mutilation is a common preschool fear. In preschool-aged children, fears related to body mutilation are common due to their developing understanding of body boundaries and functions. It is crucial for the nurse to be aware of this aspect of psychosocial development when providing care to a preschool child experiencing respiratory distress. Understanding and addressing these fears can help the nurse establish trust and rapport with the child, leading to more effective care provision. Option A is incorrect because preschool children are not yet at the stage of using complex reasoning to think through situations. Their cognitive abilities are still developing, and they rely more on concrete thinking. Option C is incorrect as preschool children are typically in the stage of parallel play rather than engaging in competitive types of play. They are learning social skills and cooperation but are not yet focused on competition. Option D is incorrect because while preschool children may exhibit behaviors related to seeking immediate gratification, it is not necessary for the development of initiative. Initiative in preschoolers is more about exploring and trying new things within their capabilities, rather than solely seeking immediate rewards.

Correct Answer: C

Rationale: Rationale: The correct answer is C) Wheat. Discharge teaching for a child with celiac disease, an autoimmune disorder triggered by gluten consumption, should include instructions to avoid wheat. Wheat contains gluten, a protein that can damage the small intestine in individuals with celiac disease. Option A) Rice is gluten-free and safe for individuals with celiac disease to consume. It is a staple food in many gluten-free diets. Option B) Milk is also gluten-free and does not pose a risk for individuals with celiac disease unless they have a separate lactose intolerance or milk allergy. Option D) Chicken is a source of protein that is naturally gluten-free and does not need to be avoided by individuals with celiac disease unless it is prepared with gluten-containing ingredients. Educational Context: It is crucial for healthcare providers to educate patients and their families about the importance of following a strict gluten-free diet to manage celiac disease effectively. By avoiding sources of gluten like wheat, individuals with celiac disease can prevent symptom flare-ups and long-term complications. Providing clear guidance on food choices and label reading empowers patients to make informed decisions about their diet and health.