Which of the following is the primary treatment for patent ductus arteriosus (PDA) in a preterm infant?

Correct Answer: B

Rationale: In the case of a preterm infant with patent ductus arteriosus (PDA), the primary treatment is indomethacin (Option B). This medication is a nonsteroidal anti-inflammatory drug that works by promoting closure of the ductus arteriosus, a crucial step in the transition from fetal to neonatal circulation. Antibiotics (Option A) are not the primary treatment for PDA, as this condition is not an infectious process. Corticosteroids (Option C) are also not indicated as the primary treatment for PDA in preterm infants. Surgery (Option D) is typically reserved for cases where medical management, such as indomethacin, has failed to close the ductus arteriosus. Educationally, it is important for pediatric clinical nurse specialists to understand the pathophysiology of PDA in preterm infants and be familiar with the appropriate pharmacological interventions. By knowing the correct treatment approach, nurses can contribute to improved outcomes for these vulnerable patients. It is crucial to stay updated on evidence-based practices in the care of preterm infants with cardiac conditions like PDA.

Correct Answer: C

Rationale: The correct answer is C) bleeding would have been avoided by using ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) like naproxen, but it is less likely to cause bleeding issues compared to naproxen. Ibuprofen has less impact on platelet function and blood clotting, making it a safer choice for pain control in this scenario. Option A is incorrect because the dose of naproxen is within the recommended range for pain control in pediatrics. Option B is incorrect because while bleeding can be a side effect of NSAIDs like naproxen, it is not the main reason for the bleeding in this case. Option D is incorrect because both naproxen and aspirin are associated with bleeding risks, but aspirin is specifically linked to Reye syndrome, not naproxen. In an educational context, understanding the differences between NSAIDs and their potential side effects is crucial for healthcare providers, especially when managing pain in pediatric patients. It is important to consider individual patient factors, such as bleeding risks, when selecting the most appropriate medication for pain control after a surgical procedure.

Correct Answer: A

Rationale: The correct answer is A) adolescents. Adolescents are the subset of children who are more likely to exhibit severe violence behavior that can persist into adulthood. During adolescence, individuals undergo significant physical, emotional, and social changes, making them more susceptible to engaging in risky behaviors, including violence. This period is crucial for identity formation and peer influence, which can contribute to violent behavior. Option B) school-aged children are typically between 6 to 12 years old and may exhibit violent behavior, but it is often less severe compared to adolescents. Option C) children of all ages with intermittent violence may display sporadic violent behavior, but it does not necessarily indicate a pattern of escalating violence seen in adolescents. Option D) preschoolers are at an early stage of development and are less likely to exhibit severe violence that continues into adulthood. In an educational context, understanding the developmental stages and risk factors associated with youth violence is crucial for pediatric clinical nurse specialists. By recognizing that adolescents are a high-risk group for persistent violent behavior, healthcare providers can implement targeted interventions, early prevention strategies, and support services to address and mitigate the long-term consequences of youth violence.

Correct Answer: D

Rationale: In the context of systemic lupus erythematosus (SLE), it is crucial for Pediatric Clinical Nurse Specialists to understand the key clinical features associated with this autoimmune condition. The correct answer, D) Hyperglycemia, is not a common feature of SLE. While individuals with SLE may experience a wide range of symptoms, hyperglycemia is not typically associated with this condition. A) Malar rash is a common feature of SLE, characterized by a butterfly-shaped rash across the cheeks and bridge of the nose. B) Arthritis is another common manifestation of SLE, with joint pain and inflammation being prevalent. C) Kidney involvement, known as lupus nephritis, is a serious complication of SLE, affecting the kidneys and potentially leading to renal failure if not managed appropriately. In an educational context, understanding the distinguishing features of SLE is essential for accurate assessment, diagnosis, and management of pediatric patients with this condition. By recognizing the key clinical manifestations of SLE, Pediatric Clinical Nurse Specialists can provide comprehensive care, monitor for complications, and collaborate effectively with the healthcare team to optimize patient outcomes.

Correct Answer: D

Rationale: In the context of the Pediatric Clinical Nurse Specialist Exam, understanding the implications of long-term corticosteroid use is crucial. The correct answer is D) All of the above. Long-term corticosteroid use can lead to a myriad of complications, including osteoporosis, hypertension, and diabetes mellitus. Osteoporosis is a well-known side effect of corticosteroid use due to its impact on bone density. Hypertension can occur as corticosteroids can cause sodium retention and increased blood volume. Diabetes mellitus is another common complication as corticosteroids can disrupt glucose metabolism. It is important for pediatric nurses to be aware of these potential complications to monitor and manage patients effectively. Educating patients and families about the risks associated with long-term corticosteroid use is essential in promoting adherence to treatment plans and mitigating these adverse effects. Understanding these complications and their management is vital for pediatric nurses to provide comprehensive care to pediatric patients requiring corticosteroid therapy. This knowledge ensures safe medication administration, close monitoring for side effects, and effective patient education regarding the importance of adherence and monitoring for signs of complications.