Which of the following is a cause of tender hepatomegaly

Correct Answer: A

Rationale: In pediatric nursing, understanding the causes of hepatomegaly is crucial for accurate assessment and diagnosis. Tender hepatomegaly is commonly associated with right-sided heart failure. In this condition, liver congestion leads to hepatomegaly, which can be tender on palpation due to the stretching of the liver capsule. Niemann-Pick disease, Biliary atresia, and Gaucher's disease are not typically associated with tender hepatomegaly. Niemann-Pick disease is a lipid storage disorder that primarily affects the spleen and brain. Biliary atresia is a congenital condition characterized by the absence or obstruction of the bile ducts, leading to jaundice and liver damage but not necessarily tender hepatomegaly. Gaucher's disease is a lipid storage disorder that primarily affects the spleen and bone marrow. Educationally, understanding the different causes of hepatomegaly in pediatrics is essential for nurses and healthcare providers to differentiate between various conditions accurately. This knowledge helps in prompt identification, appropriate referral, and timely interventions, ultimately improving patient outcomes.

Correct Answer: B

Rationale: In pediatric nursing, the 'look, listen, feel' approach is a fundamental skill used to assess a child's breathing. This technique involves observing the rise and fall of the chest (look), listening for breath sounds (listen), and feeling for air movement (feel). Option A (Circulation) is incorrect because assessing circulation involves checking for a pulse, skin color, and capillary refill time, which are not part of the 'look, listen, feel' technique. Option C (Airway patency) is incorrect because while airway patency is crucial for effective breathing, it is assessed by checking for signs of airway obstruction, such as stridor or wheezing, and not solely through the 'look, listen, feel' method. Option D (Consciousness) is incorrect because assessing consciousness involves evaluating the child's level of alertness and responsiveness, which is a separate aspect of the pediatric assessment. Understanding the 'look, listen, feel' technique is essential for pediatric nurses as it allows for a systematic and comprehensive assessment of a child's breathing, which is vital for identifying respiratory distress or failure early on. By mastering this skill, nurses can promptly intervene and provide appropriate care to ensure optimal outcomes for pediatric patients.

Correct Answer: B

Rationale: In pediatric patients, recognizing early signs of shock is crucial for timely intervention. The correct answer is B) Tachypnea, which refers to rapid breathing. In shock, the body tries to compensate by increasing respiratory rate to improve oxygen intake. This is an early sign seen before other vital signs like blood pressure and heart rate are affected. Option A) Hypotension, is a late sign of shock in pediatric patients. By the time blood pressure drops, the shock is usually advanced. Option C) Lethargy, and option D) Bradycardia, are also late signs of shock and indicate decompensation. Educationally, understanding the progression of shock signs in pediatric patients is essential for nurses and healthcare providers. Recognizing early signs like tachypnea can prompt quick assessment and treatment, potentially preventing the progression to severe shock. This knowledge can help improve patient outcomes and reduce morbidity and mortality in pediatric populations.

Correct Answer: B

Rationale: In pediatric nursing, identifying early signs of shock is crucial for prompt intervention to prevent further deterioration. In this scenario, the correct answer is B) Irritability. Irritability is an early sign of shock in children because it reflects the body’s physiological response to decreased tissue perfusion and oxygenation. Children in shock may exhibit irritability due to their body's attempt to compensate for the inadequate oxygen supply by increasing sympathetic tone, leading to restlessness and agitation. Option A) Cyanosis typically occurs in later stages of shock when oxygen saturation is significantly compromised, making it a late sign rather than an early one. Option C) Lethargy is also a late sign of shock, indicating severe tissue hypoxia. Option D) Irregular breathing may occur in shock but is not as specific or sensitive as irritability in the early stages. Educationally, understanding the early signs of shock in pediatric patients is essential for nurses to provide timely and appropriate care. Teaching about these subtle cues can help healthcare professionals recognize shock early, intervene promptly, and potentially improve outcomes for pediatric patients in critical condition.

Correct Answer: C

Rationale: The most accepted diagnostic criteria for asthma is recurrent cough or wheeze that responds to bronchodilator therapy, which is option C. This is because asthma is characterized by airway inflammation and hyperresponsiveness, leading to symptoms like coughing and wheezing that improve with bronchodilators. Option A, cough or wheeze in a child who has tested positive for allergens, is not specific to asthma as other conditions like allergic rhinitis can also present similarly. Option B, a strong family history of asthma, is a risk factor but not a definitive diagnostic criterion. Option D, passive smoking exposure, can exacerbate asthma but is not a stand-alone diagnostic criterion. In an educational context, understanding the diagnostic criteria for asthma is crucial for nurses caring for pediatric patients. Recognizing the clinical presentation and response to treatment helps in early identification and management of asthma in children, improving outcomes and quality of life. It is important to differentiate asthma from other respiratory conditions to provide appropriate care and education to patients and their families.