Which of the following causes hyperkalemia with K+ excess:

Correct Answer: C

Rationale: In pediatric nursing, understanding electrolyte imbalances like hyperkalemia is crucial for providing safe and effective care to children. In this scenario, the correct answer is C) Addison's disease. Addison's disease is associated with primary adrenal insufficiency, leading to decreased aldosterone secretion. Aldosterone plays a key role in potassium regulation in the body. With decreased aldosterone levels, potassium excretion by the kidneys is impaired, resulting in hyperkalemia with K+ excess. Option A) Tumor lysis syndrome is incorrect because it typically causes hyperphosphatemia and hypocalcemia, not hyperkalemia. Option B) Metabolic acidosis can lead to hyperkalemia due to a shift of potassium out of cells, but it is not directly related to K+ excess. Option D) Rhabdomyolysis can cause hyperkalemia due to the release of intracellular potassium from damaged muscle cells, but it is not primarily associated with K+ excess. Educationally, this question highlights the importance of understanding the pathophysiology of electrolyte imbalances in pediatric patients. It emphasizes the need for nurses to recognize the underlying conditions that can lead to hyperkalemia and implement appropriate interventions to manage and prevent complications associated with this electrolyte disturbance.

Correct Answer: A

Rationale: In the context of pediatric nursing and acute leukemia, it is crucial to understand the different aspects of the disease to provide safe and effective care to pediatric patients. In this question, the false statement is option A: "Radiation therapy has a role in leukemia therapy." The correct answer is A because radiation therapy is not a common treatment modality for leukemia in pediatric patients. Instead, the mainstays of treatment for acute leukemia in children typically involve chemotherapy, targeted therapy, and in some cases, stem cell transplantation. Radiation therapy is more commonly used in the treatment of solid tumors, rather than leukemia. Option B, "Anemia is poor prognostic value," is incorrect because anemia is indeed a poor prognostic indicator in patients with acute leukemia. It is often associated with advanced disease and may indicate bone marrow involvement, leading to a poorer prognosis. Option C, "Blast cell more than 25% in bone marrow is diagnostic," is incorrect because a blast cell percentage of more than 20% in the bone marrow is one of the criteria used to diagnose acute leukemia. This high blast count indicates a rapid proliferation of immature cells, which is characteristic of leukemia. Option D, "Leukocytic count more than 100,000 is called hyperleukocytosis," is incorrect because hyperleukocytosis is defined as a very high white blood cell count, typically greater than 100,000/mm3. This condition can lead to complications such as leukostasis and requires prompt management to prevent serious consequences. In an educational context, understanding the nuances of leukemia diagnosis and treatment is essential for pediatric nurses caring for children with this condition. By knowing the correct information, nurses can provide appropriate care, monitor for potential complications, and support the child and their family throughout the treatment process.

Correct Answer: C

Rationale: The correct combination of the 'famous triad' in acute leukemia is Fever - Pallor - Purpura (Option C). This triad is specifically seen in acute lymphocytic leukemia (ALL). - Fever: Children with ALL often present with fever due to infections resulting from the decreased production of normal white blood cells. - Pallor: Anemia is common in leukemia, leading to pallor due to decreased red blood cell production. - Purpura: Purpura, or easy bruising and bleeding, is a result of low platelet counts in leukemia. Now, let's analyze why the other options are incorrect: - Option A: Abdominal enlargement is more commonly associated with hepatosplenomegaly in leukemia, but it is not a part of the 'famous triad.' - Option B: Bone aches are common in leukemia, but they do not form the classic triad seen in ALL. - Option D: Lymphadenopathy is not typically part of the 'famous triad' of symptoms in acute leukemia. In an educational context, understanding these triads helps healthcare providers quickly recognize and diagnose pediatric patients with acute leukemia, leading to prompt treatment and better outcomes. Remembering key symptom combinations is crucial for clinical practice and can make a significant impact on patient care.

Correct Answer: D

Rationale: The correct answer is D) acceptable to encourage head control and turning over. This response is based on the developmental stage of a 3-month-old infant. At this age, infants are typically developing head control and starting to learn how to turn over. Allowing the infant to have supervised tummy time while awake helps strengthen their neck muscles, promote head control, and eventually leads to the ability to roll over. This position also helps prevent flat spots on the back of the infant's head. Option A) is incorrect because placing the infant on their tummy while awake and supervised does not increase the risk of Sudden Infant Death Syndrome (SIDS). In fact, the American Academy of Pediatrics recommends supervised tummy time to promote motor development and prevent positional plagiocephaly (flat head syndrome). Option B) is incorrect because placing the infant on their tummy while awake actually encourages the achievement of developmental milestones such as head control, rolling over, and eventually crawling. Option C) is incorrect because while tummy time does support overall motor development, the primary purpose at 3 months is to encourage head control and the ability to turn over. It is not specifically focused on fine motor development at this stage. In an educational context, understanding the importance of tummy time and its role in promoting infant development is crucial for pediatric nurses. By educating parents on the benefits of supervised tummy time, nurses can empower them to actively participate in their child's motor skill development and overall well-being.

Correct Answer: C

Rationale: In pediatric nursing, understanding infant development milestones is crucial for providing appropriate care and support. The correct answer to the question is C) 3 months. At around 3 months of age, infants typically start to recognize familiar faces and objects, such as a feeding bottle. At 1 month (option A), infants are still in the early stages of visual development and may not yet have the ability to consistently recognize specific objects or faces. At 2 months (option B), while infants start to show more interest in their surroundings, their ability to differentiate and recognize specific objects is still developing. By 4 months (option D), most infants have already started to establish familiarity with important objects and people in their environment, thus making option D less likely as the correct answer. Educationally, understanding these developmental milestones helps nurses and healthcare providers assess the growth and progress of infants, identify any potential developmental delays, and provide appropriate interventions or support as needed. It also enables caregivers to engage in activities that promote cognitive and social development in infants.