Which is the BEST indication for rigid bronchoscopy?

Correct Answer: B

Rationale: In pediatric respiratory distress, the BEST indication for rigid bronchoscopy is option B) extracting foreign bodies. This is because rigid bronchoscopy is the preferred method for removing foreign bodies from the airway in children due to its larger working channel, better visualization, and ability to manage complications effectively. Foreign body aspiration can lead to life-threatening airway obstruction, making prompt removal crucial. Option A) persistent wheeze is not a primary indication for rigid bronchoscopy. Wheezing can be caused by various respiratory conditions that may not require bronchoscopy for diagnosis or treatment. Option C) atelectasis can sometimes be managed conservatively or with other interventions before considering bronchoscopy. Option D) persistent bronchitis or bronchiolitis typically do not necessitate rigid bronchoscopy unless there is a specific indication, such as suspected airway obstruction or other complications. Educationally, understanding the appropriate indications for rigid bronchoscopy in pediatric patients is crucial for nurses caring for children with respiratory distress. It is essential to recognize when this intervention is warranted to ensure timely and effective management of potentially life-threatening situations like foreign body aspiration. Nurses must be knowledgeable about the different respiratory conditions and their respective management strategies to provide optimal care to pediatric patients.

Correct Answer: A

Rationale: In the pediatric population, antiphospholipid antibody syndrome is a commonly encountered risk factor for deep venous thrombosis (DVT) and pulmonary embolism (PE). This autoimmune disorder leads to an increased risk of blood clots due to the presence of antibodies that target phospholipids in the blood vessel walls, promoting clot formation. Option A, antiphospholipid antibody syndrome, is the correct answer because it directly predisposes individuals, including children, to thrombotic events. Hematologic malignancies (Option B), although they can increase the risk of thrombosis, are not as commonly associated with DVT and PE in the pediatric population as antiphospholipid antibody syndrome. Sickle cell disease (Option C) is more closely linked to vaso-occlusive crises and acute chest syndrome rather than DVT and PE. Nephrotic syndrome (Option D) can lead to hypercoagulability, but it is not as prevalent a risk factor for DVT and PE in children as antiphospholipid antibody syndrome. Educationally, understanding the unique risk factors for DVT and PE in pediatric patients is crucial for nurses caring for this population. Recognizing the association between antiphospholipid antibody syndrome and thrombotic events can guide preventative measures and prompt early intervention to reduce the risk of life-threatening complications such as PE. Identifying and addressing these risk factors promptly can significantly improve patient outcomes and quality of care.

Correct Answer: D

Rationale: In this question on pectus excavatum (funnel chest), the correct answer is D) >90% have a positive family history. This is the correct answer because pectus excavatum is known to have a genetic component, with a strong likelihood of being present in family members of affected individuals. Option A) occurs in 1:400 births is incorrect because pectus excavatum is a relatively common congenital chest wall deformity, affecting around 1 in 400 births. Option B) associated with a connective tissue disorder is incorrect. Pectus excavatum is primarily a skeletal deformity and is not typically associated with connective tissue disorders. Option C) usually becomes apparent in the neonatal period is also incorrect. While some cases of pectus excavatum may be noticeable in infancy, it typically becomes more prominent as the child grows and the chest wall develops. Educationally, understanding the features of pectus excavatum is crucial for healthcare providers, especially in pediatric nursing, as it helps in early identification, appropriate interventions, and family education. Knowing that there is a strong familial link can guide healthcare providers in assessing other family members and providing genetic counseling if needed.

Correct Answer: A

Rationale: The correct answer is A) Hepatocyte giant cells. In the context of a liver biopsy, the presence of hepatocyte giant cells is indeed characteristic. Hepatocyte giant cells are multinucleated cells that can be seen in certain liver diseases, such as viral hepatitis or drug-induced liver injury. They are not normally present in healthy liver tissue. Option B) Cholestasis is incorrect because it refers to a condition where bile flow from the liver is impaired, leading to the accumulation of bile in the liver. This does not specifically relate to the presence of hepatocyte giant cells in a liver biopsy. Option C) Portal triads are structures in the liver that consist of a branch of the portal vein, hepatic artery, and bile duct. While important for liver function, they are not directly related to the presence of hepatocyte giant cells. Option D) Paucity of bile ducts is a term used to describe a condition where there is a decreased number of bile ducts in the liver. This is typically seen in conditions like Alagille syndrome and is not directly linked to the presence of hepatocyte giant cells. In an educational context, understanding the histological features seen in liver biopsies is crucial for nurses caring for pediatric patients with liver diseases. Recognizing hepatocyte giant cells can aid in the diagnosis and management of these conditions, highlighting the importance of histopathology in clinical practice.

Correct Answer: C

Rationale: In pediatric respiratory distress, understanding the most common causes of obstructive sleep apnea syndrome (OSA) is crucial for effective nursing interventions. The correct answer is C) Adenotonsillar hypertrophy. Adenotonsillar hypertrophy, the enlargement of the tonsils and adenoids, is a common cause of OSA in young children due to the obstruction of the upper airway during sleep. This obstruction leads to pauses in breathing, fragmented sleep, and decreased oxygen levels, resulting in respiratory distress. Option A) Obesity can be a risk factor for OSA in adults but is less common in young children. Craniofacial malformations (Option B) may contribute to airway issues but are not as prevalent as adenotonsillar hypertrophy in causing OSA in this population. Neuromuscular diseases (Option D) can also lead to respiratory problems, but they are not the most common cause of OSA in young children. Educationally, nurses need to recognize the signs and symptoms of OSA in pediatric patients, including snoring, gasping during sleep, and daytime fatigue. By understanding the primary causes like adenotonsillar hypertrophy, nurses can advocate for appropriate referrals, such as to an otolaryngologist for further evaluation and potential surgical intervention, to alleviate the respiratory distress and improve the child's quality of life.