Which of the following is a feature of early (compensated) shock:

Correct Answer: B

Rationale: In pediatric nursing, understanding the features of shock is crucial for timely intervention and effective patient care. In the context of early (compensated) shock, the correct feature is tachycardia (Option B). Tachycardia is a compensatory mechanism the body uses to maintain perfusion to vital organs in response to decreased intravascular volume, which is characteristic of early shock. Option A, hypotension, is a feature of late (decompensated) shock. In the compensatory phase, the body tries to maintain blood pressure by increasing heart rate, so hypotension is not typically seen. Option C, decreased level of consciousness, and Option D, cold extremities, are also signs of late shock when perfusion to vital organs is severely compromised. Educationally, it is important for nursing students to grasp the progressive stages of shock and recognize the subtle early signs like tachycardia. This knowledge enables prompt recognition and intervention, potentially preventing the progression to more severe stages of shock. Understanding these nuances is essential for providing safe and effective care to pediatric patients in critical conditions.

Correct Answer: C

Rationale: In the context of pediatric nursing, understanding the causes of hyperkalemia is crucial for providing safe and effective care to pediatric patients. In this question, the correct answer is C) Addison's disease. Addison's disease is a condition characterized by adrenal insufficiency, leading to decreased production of aldosterone. Aldosterone plays a key role in potassium regulation in the body. In Addison's disease, the lack of aldosterone results in impaired excretion of potassium by the kidneys, leading to hyperkalemia. Option A) Tumor lysis syndrome is known to cause hyperkalemia, but it does so through a different mechanism. Tumor lysis syndrome results from the rapid breakdown of cancer cells, releasing intracellular contents, including potassium, into the bloodstream. Option B) Metabolic acidosis can also lead to hyperkalemia due to a shift of potassium from the intracellular to the extracellular space in an acidic environment. However, it is not directly related to K+ excess. Option D) Rhabdomyolysis can cause hyperkalemia due to the release of potassium from damaged muscle cells into the bloodstream. While it is a potential cause of hyperkalemia, it is not specifically related to K+ excess as in Addison's disease. Understanding the specific causes of hyperkalemia in pediatric patients is essential for accurate assessment, diagnosis, and treatment. By grasping the unique pathophysiology of conditions like Addison's disease, nurses can provide targeted interventions to manage hyperkalemia effectively and prevent complications in pediatric patients.

Correct Answer: B

Rationale: In pediatric nursing, understanding different types of anemia is crucial for providing effective care to children. In this case, the correct answer is B) Iron deficiency anemia, which is a microcytic hypochromic anemia. Iron deficiency anemia is characterized by small (microcytic) and pale (hypochromic) red blood cells due to insufficient iron for hemoglobin synthesis. It is a common type of anemia in children, often caused by inadequate dietary intake, blood loss, or poor absorption. A) Aplastic anemia is a normocytic normochromic anemia caused by bone marrow failure, leading to a decrease in all blood cell types. C) Leukemia is a type of cancer affecting white blood cells and does not present as microcytic hypochromic anemia. D) Sickle cell anemia is a hemolytic anemia characterized by sickle-shaped red blood cells due to a genetic mutation affecting hemoglobin. Educationally, this question reinforces the importance of recognizing different types of anemia in pediatric patients and understanding their etiology, clinical manifestations, and treatment approaches. It highlights the significance of thorough assessment and diagnostic skills in providing quality care to children with hematologic disorders.

Correct Answer: A

Rationale: In the context of pediatric nursing exam preparation, understanding acute leukemia is crucial. The correct answer is A) Radiation therapy has a role in leukemia therapy. This statement is false because radiation therapy is generally not a primary treatment for leukemia in children due to its harmful effects on developing tissues and the risk of secondary cancers. Option B) Anemia is poor prognostic value is incorrect because anemia is actually a common finding in leukemia but alone does not determine the prognosis. Other factors like type of leukemia, genetic abnormalities, and response to treatment play a more significant role in prognosis. Option C) Blast cell more than 25% in bone marrow is diagnostic is incorrect as the diagnosis of acute leukemia is based on the presence of at least 20% blasts in the bone marrow or peripheral blood, not specifically 25%. Option D) Leukocytic count more than 100,000 is called hyperleukocytosis is incorrect as hyperleukocytosis is defined as a leukocyte count greater than 50,000, not 100,000. Educationally, it is important for pediatric nurses to have a solid understanding of leukemia, including its diagnostic criteria, treatment modalities, and prognostic factors to provide optimal care for pediatric patients with this condition. Understanding the nuances of leukemia management helps nurses advocate for appropriate treatment plans and provide comprehensive support to patients and their families.

Correct Answer: C

Rationale: The correct answer is C) Fever - Pallor - Purpura, which represents the famous triad seen in acute leukemia. This combination is indicative of the classic symptoms associated with acute leukemia in pediatric patients. Fever is a common presenting symptom in leukemia due to the body's response to the abnormal production of leukemic cells. Pallor results from anemia, which is a common hematological manifestation of leukemia. Purpura, which refers to small hemorrhages under the skin, mucous membranes, or internal organs, can occur due to the decreased platelet count in leukemia. Option A) Fever - Pallor - Abdominal enlargement is incorrect because abdominal enlargement is more commonly associated with conditions like hepatomegaly or splenomegaly, which can occur in leukemia but are not part of the classic triad. Option B) Pallor - Purpura - Bone aches is incorrect as bone aches are a common symptom in leukemia but not part of the classic triad. Option D) Purpura - Fever - Lymphadenopathy is incorrect because lymphadenopathy (enlarged lymph nodes) is not typically part of the classic triad seen in acute leukemia. Understanding these classic triads and symptom clusters in pediatric nursing is crucial for early identification and prompt management of conditions like acute leukemia, emphasizing the importance of comprehensive pediatric nursing exam preparation.