What is the most common complication of premature rupture of membranes (PROM)?

Correct Answer: A

Rationale: In the context of pediatric respiratory distress, understanding the complications of premature rupture of membranes (PROM) is crucial for nurses. The most common complication of PROM is infection (Option A). When the amniotic sac ruptures before term, it exposes the fetus to the vaginal flora, increasing the risk of ascending infections such as chorioamnionitis, which can lead to neonatal sepsis and respiratory distress. Option B, preterm labor, is a consequence of PROM but not the most common complication. PROM can indeed trigger contractions and premature delivery, but infection remains the primary concern. Placental abruption (Option C) and fetal growth restriction (Option D) are not directly related to PROM. Placental abruption is the separation of the placenta from the uterine wall, leading to fetal distress but not a common complication of PROM. Fetal growth restriction may occur due to various factors but is not the immediate concern following PROM. Educationally, this question highlights the importance of recognizing the potential complications of PROM in pediatric nursing. Nurses need to be vigilant in monitoring for signs of infection in neonates born to mothers with PROM to provide timely interventions and prevent respiratory distress and other serious complications.

Correct Answer: C

Rationale: In the management of a neonate with congenital diaphragmatic hernia (CDH), the first-line management is surgical repair (Option C). This is the correct option because CDH is a condition where abdominal organs herniate into the chest cavity, compromising lung development and leading to respiratory distress. Surgical repair is necessary to reposition the organs back into the abdomen, allowing the lungs to expand properly and function effectively. Option A, mechanical ventilation, may be required post-surgery to support the neonate's respiratory function during recovery. However, it is not the first-line treatment for CDH. Surfactant therapy (Option B) is used in conditions like respiratory distress syndrome (RDS) where there is a deficiency of surfactant in the lungs, not in CDH. Positive pressure ventilation (Option D) may be used to support respiratory function, but it is not the primary treatment for CDH. Educationally, understanding the correct management of CDH is crucial for nursing interventions in pediatric respiratory distress. It is essential for nurses caring for neonates with CDH to recognize the importance of prompt surgical repair to optimize outcomes and provide comprehensive care for these vulnerable patients.

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.