When planning care for a 8-year-old boy with Down syndrome, the nurse should:

Correct Answer: C

Rationale: In caring for a child with Down syndrome, it is crucial to assess the individual child's current developmental level and plan care accordingly. Option C is the correct answer because children with Down syndrome can have a wide range of developmental abilities and challenges. By assessing the child's specific developmental level, the nurse can tailor interventions to meet the child where they are at and support their individual needs effectively. Option A is incorrect because assuming the child's developmental level based solely on chronological age can overlook the unique developmental profile of a child with Down syndrome. Option B is also incorrect as it generalizes developmental delays without considering the variability in abilities seen in children with Down syndrome. Option D is not appropriate as it dismisses the child's capacity to understand and learn, which is not aligned with a person-centered approach to care. In an educational context, this question highlights the importance of individualized care planning for children with developmental differences like Down syndrome. It emphasizes the need for healthcare providers to assess each child's unique needs and abilities to provide effective and person-centered care. Understanding the complexities of caring for pediatric patients with special needs is essential for healthcare professionals working in diverse clinical settings.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Iron-rich formula and baby food. The rationale behind this is that after 5 months, breast milk alone may not provide sufficient iron for the infant's growth and development. Iron-rich formula can help meet the baby's iron needs as they transition from breast milk. Baby food is also important at this stage to introduce new textures and flavors to the infant's diet as they start weaning off breast milk. Option B) Whole milk is not recommended for infants under 1 year of age as it can be difficult for their digestive system to handle. Option C) Skim milk is also not appropriate for infants as it lacks essential fats and nutrients necessary for their growth. Option D) Iron-rich formula only would not provide the variety of nutrients and textures needed for the baby's development at this stage. In an educational context, it is crucial for nurses to understand the nutritional needs of infants at different stages of development. By providing accurate and evidence-based information to mothers, nurses can support them in making informed decisions about their child's diet and ensure optimal growth and development. This question highlights the importance of appropriate feeding practices during the weaning period for infants.

Correct Answer: D

Rationale: In this scenario, option D, "History of steroid-dependent asthma," is the correct answer indicating a child is at risk for a severe asthma exacerbation. Children with steroid-dependent asthma have a history of severe and recurrent asthma attacks, requiring long-term steroid therapy. This places them at higher risk for exacerbations due to the chronic nature of their condition and potential for poor asthma control. Option A, "Oxygen saturation of 95%," may seem like a good sign, but in asthma exacerbations, oxygen saturation can initially be maintained before dropping rapidly during a severe attack. Therefore, a child with a history of severe asthma exacerbations may still be at risk despite a seemingly normal oxygen saturation level. Option B, "Mild work of breathing," and option C, "Absence of intercostals or substernal retractions," both suggest a lack of significant respiratory distress. However, in severe asthma exacerbations, children may not exhibit these signs until the condition rapidly deteriorates. This emphasizes the importance of considering the child's medical history and risk factors for predicting severe asthma exacerbations. Educationally, this question highlights the critical role of recognizing risk factors in pediatric asthma management. Understanding a child's medical history, especially in chronic conditions like asthma, can help healthcare providers anticipate and prevent severe exacerbations. It also underscores the need for proactive monitoring and early intervention in children with a history of severe asthma to prevent potentially life-threatening situations.

Correct Answer: D

Rationale: Rationale: In a child with coarctation of the aorta, there is a narrowing of the aorta, typically near the insertion of the ductus arteriosus. This narrowing leads to increased pressure proximal to the defect and decreased pressure distal to the defect. When measuring blood pressure on all four extremities, the nurse would expect to find a significant difference in blood pressure readings between the upper extremities (arms) and the lower extremities (legs). Correct Answer (D): Blood pressure lower in the legs than in the arms. This is because the narrowing of the aorta in coarctation of the aorta leads to decreased blood flow to the lower extremities, resulting in lower blood pressure readings in the legs compared to the arms. Incorrect Answer Choices: A) Blood pressure higher on the right side: This is incorrect as coarctation of the aorta does not specifically affect one side of the body over the other. B) Blood pressure higher on the left side: Similar to option A, coarctation of the aorta does not lead to unilateral differences in blood pressure. C) Blood pressure lower in the arms than in the legs: This is incorrect as coarctation of the aorta causes higher blood pressure in the arms due to the increased pressure proximal to the defect. Educational Context: Understanding the pathophysiology of coarctation of the aorta is crucial in recognizing the clinical manifestations associated with this condition. By assessing blood pressure differentials between the upper and lower extremities, healthcare providers can suspect coarctation of the aorta and initiate appropriate diagnostic and treatment interventions promptly. This knowledge is vital for nurses working in pediatric settings to provide safe and effective care for children with cardiovascular conditions.

Correct Answer: B

Rationale: In this scenario, option B, "He tires out during feedings," is the correct choice that would alert the nurse about the presence of a congenital heart defect in a 1-month-old infant. Infants with congenital heart defects may display symptoms such as fatigue during feeding due to the increased effort required by the heart to pump blood effectively. This can lead to poor feeding, inadequate weight gain, and failure to thrive. Option A, "He is always hungry," is incorrect as it is a common behavior in infants and does not specifically indicate a heart defect. Option C, "He is fussy for several hours every day," could be due to various reasons such as colic or general infant fussiness and does not directly point to a heart condition. Option D, "He sleeps all the time," is also non-specific and could be a normal pattern for a newborn. Educationally, understanding the signs and symptoms of congenital heart defects in infants is crucial for nurses and healthcare providers working in pediatric settings. Early recognition and intervention can significantly impact the outcomes for these infants. It is essential to educate parents on what to observe and report to healthcare providers to ensure timely diagnosis and management of congenital heart defects.