Which is the leading cause of death after heart transplantation?

Correct Answer: B

Rationale: The posttransplant course is complex. The leading cause of death after cardiac transplantation is rejection. Infection is a continued risk secondary to the immunosuppression necessary to prevent rejection. Cardiomyopathy is one of the indications for cardiac transplant. Heart failure is not a leading cause of death.

Correct Answer: B

Rationale: In pediatric nursing, understanding the etiology of various cardiovascular disorders is crucial for effective patient care. In this context, the correct answer is B) Vitamin D dependent rickets type 2. This condition primarily results from a mutation in the gene encoding the Vitamin D receptor. Vitamin D dependent rickets type 1 (Option A) is caused by mutations in the CYP27B1 gene, leading to impaired activation of Vitamin D. X-linked hypophosphatemic rickets (Option C) is caused by mutations in the PHEX gene, affecting phosphate regulation. Autosomal dominant hypophosphatemic rickets (Option D) is caused by mutations in the FGF23 gene, disrupting phosphate metabolism. Educationally, understanding the genetic basis of various rickets types is essential for nurses caring for pediatric patients with cardiovascular disorders. This knowledge helps in accurate diagnosis, treatment planning, and patient education regarding the inheritance patterns and long-term management of these conditions. By grasping the genetic underpinnings, nurses can provide holistic care and support to pediatric patients and their families.

Correct Answer: B

Rationale: In pediatric nursing, understanding the recommended hourly maintenance fluid rate for children is crucial as it directly impacts their hydration and overall well-being. For a 20 kg child, the recommended hourly maintenance fluid rate is 4 mL/kg for the first 10 kg of body weight and then 2 mL/kg for the next 10 kg. Here's a detailed rationale for the correct answer (B - 60 ml/hour): The calculation for a 20 kg child would be: - 10 kg x 4 mL/kg = 40 mL for the first 10 kg - 10 kg x 2 mL/kg = 20 mL for the next 10 kg - Total = 40 mL + 20 mL = 60 mL/hour Explanation of why the other options are incorrect: A) 50 ml/hour: This option is lower than the calculated rate for a 20 kg child, which could potentially lead to inadequate hydration. C) 80 ml/hour: This option is higher than the calculated rate, which could result in overhydration and potential complications. D) 100 ml/hour: This option is also higher than the calculated rate and could lead to excessive fluid intake, increasing the risk of fluid overload in the child. Educational context: Understanding the principles of pediatric fluid maintenance is essential for nurses to provide safe and effective care to pediatric patients. By knowing the correct calculations for fluid rates based on a child's weight, nurses can prevent dehydration or fluid overload, both of which can have serious consequences for a child's health. It is important to always calculate and administer fluids accurately to ensure optimal patient outcomes.

Correct Answer: B

Rationale: Pediatric nursing students need to understand transient neonatal pustular melanosis (TNPM) to provide optimal care for newborns. Option B is incorrect because TNPM does not typically present with intracorneal or subcorneal pustules filled with eosinophils. The correct answer is A. Increased melanization of epidermal cells is characteristic of TNPM. Option C is true as the pustular phase of TNPM usually resolves within 2-3 days. Option D is also accurate as lesions of pustular melanosis do not contain bacteria. Educationally, it is vital for students to grasp the differences in neonatal skin conditions to make accurate diagnoses and provide appropriate care. Understanding the key features of TNPM, such as the absence of intracorneal or subcorneal pustules, helps students differentiate it from other skin conditions. By explaining why each option is correct or incorrect, students can deepen their knowledge and develop critical thinking skills essential for clinical practice in pediatric nursing.

Correct Answer: D

Rationale: In pediatric nursing, understanding developmental milestones is crucial for assessing normal growth and development. Bed-wetting, also known as enuresis, is a common concern for parents. The correct answer, D) 5 years in both boys and girls, is based on developmental norms. Children typically achieve nighttime continence by the age of 5. Boys and girls may vary in the age at which they achieve this milestone, but by the age of 5, most children should be able to stay dry through the night. Therefore, option D is correct as it reflects this developmental expectation. Option A) 4 years in boys and 5 years in girls is incorrect because it reverses the typical trend of girls achieving bladder control earlier than boys. Option B) 5 years in boys and 4 years in girls is also incorrect for the same reason. Option C) 4 years in both boys and girls is incorrect as it does not account for the developmental differences between boys and girls in achieving nighttime continence. Educationally, this question highlights the importance of understanding normal developmental milestones in pediatric nursing practice. By knowing these norms, nurses can provide appropriate guidance and support to parents and caregivers, helping them differentiate between normal developmental variations and potential concerns.