Which intervention should the nurse plan to decrease cardiac demands in an infant with congestive heart disease (CHD)?

Correct Answer: A

Rationale: The infant requires rest and conservation of energy for feeding. Every effort is made to organize nursing activities to allow for uninterrupted periods of sleep. Whenever possible, parents are encouraged to stay with their infant to provide the holding, rocking, and cuddling that help children sleep more soundly. To minimize disturbing the infant, changing bed linens and complete bathing are done only when necessary. Feeding is planned to accommodate the infant’s sleep and wake patterns. The child is fed at the first sign of hunger, such as when sucking on fists, rather than waiting until he or she cries for a bottle because the stress of crying exhausts the limited energy supply. Because infants with CHD tire easily and may sleep through feedings, smaller feedings every 3 hours may be helpful.

Correct Answer: D

Rationale: In pediatric nursing, understanding developmental milestones is crucial for assessing a child's growth and identifying any delays early on. In this context, the correct answer, option D, states that developmental delay in children below 3 years of age is defined as a 30% departure from typical performance in any developmental domain. This definition is appropriate because developmental delays are not limited to specific domains but can manifest in various areas such as motor skills, language, social skills, and cognitive abilities. A delay in any of these areas can significantly impact a child's overall development and may require early intervention to address. Options A, B, and C are incorrect because they either limit the definition of developmental delay to specific domains or underestimate the degree of departure from typical development that would warrant concern. By setting the threshold at 30% in any developmental domain, option D provides a more comprehensive and inclusive criterion for identifying developmental delays in young children. Educationally, this question highlights the importance of understanding and recognizing developmental delays in pediatric patients. Nurses and healthcare providers need to be vigilant in monitoring children's developmental progress, as early intervention can lead to better outcomes for children with delays. By knowing the criteria for defining developmental delay, healthcare professionals can work collaboratively with families to support children's optimal growth and development.

Correct Answer: B

Rationale: In pediatric nursing, understanding delayed tooth eruption is essential for providing comprehensive care to children. The correct answer, option B, is incorrect because delayed tooth eruption is defined as no teeth eruption by 18 months of age, not 15 months as stated. This is a critical distinction as it guides healthcare providers in assessing and monitoring a child's dental development accurately. Option A states that the most common cause of delayed tooth eruption is idiopathic, which is correct. Many cases of delayed tooth eruption have no identifiable cause, emphasizing the importance of regular monitoring and follow-up for affected children. Option C mentions mechanical blockade as a cause of delayed tooth eruption. While this can be a contributing factor in some cases, it is not the most common cause and may require specific interventions or referrals for proper management. Option D highlights the need to rule out systemic conditions like hypothyroidism and hypoparathyroidism in cases of delayed tooth eruption. These conditions can impact dental development and overall health, underlining the importance of a thorough assessment by healthcare providers. Educationally, understanding the nuances of delayed tooth eruption is crucial for pediatric nurses as they play a key role in early detection, referral, and support for children with dental concerns. By grasping the correct definition and common causes of delayed tooth eruption, nurses can provide informed care and support to promote optimal oral health outcomes in pediatric patients.

Correct Answer: A

Rationale: In pediatric nursing, understanding the criteria for recurrent pneumonia is crucial for early identification and intervention to prevent complications. The correct answer is A) 2 episodes in 6 months. This definition is based on the frequency of episodes within a specific time frame that is indicative of an increased risk for underlying conditions such as immune deficiencies or anatomical abnormalities. Option B) 2 episodes in one year is incorrect because waiting for a whole year to identify recurrent pneumonia may delay necessary interventions and increase the risk of complications. Option C) 3 episodes ever without radiographic clearance is incorrect because it does not consider the timeframe within which the episodes occur, which is essential for timely management. Option D) 4 episodes ever with radiographic clearance is incorrect because the presence of radiographic clearance does not negate the impact of recurrent pneumonia on the child's health and the need for further evaluation. Educationally, understanding the definition of recurrent pneumonia in children helps nurses and healthcare providers to promptly assess and manage these cases, leading to better outcomes for pediatric patients. It also highlights the importance of monitoring respiratory health in children and the need for a proactive approach in identifying potential underlying issues.

Correct Answer: A

Rationale: In pediatric pharmacology, understanding the interaction between bilirubin and albumin is crucial due to the implications for conditions like jaundice in newborns. The correct answer is A) 8.5 mg because 1 gm of albumin can bind approximately 8.5 mg of bilirubin. Albumin is the major protein responsible for binding and transporting bilirubin in the blood. This binding capacity is essential for preventing the accumulation of free, unconjugated bilirubin which can be neurotoxic. Option B) 9.8 mg, Option C) 10.5 mg, and Option D) 13.6 mg are incorrect because they exceed the known binding capacity of 1 gm of albumin. Understanding this binding capacity is vital in clinical practice, particularly when assessing neonates for hyperbilirubinemia and determining the need for interventions such as phototherapy or exchange transfusions. Educationally, this question reinforces the importance of accurate dosing calculations and understanding the specific interactions between drugs and binding proteins in pediatric patients. It highlights the need for precision in medication administration to prevent adverse effects related to drug-protein interactions, especially in vulnerable populations like pediatric patients.