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 a patent ductus arteriosus (PDA), the primary treatment is typically indomethacin (Option B). Indomethacin is a nonsteroidal anti-inflammatory drug that helps to close the PDA by inhibiting prostaglandin synthesis. This medication is effective in promoting ductal closure in many preterm infants with PDA. Antibiotics (Option A) are not the primary treatment for PDA. PDA is a cardiac condition related to the persistence of a fetal connection between the aorta and pulmonary artery. Antibiotics do not address the underlying issue of the open ductus arteriosus. Corticosteroids (Option C) are not the primary treatment for PDA either. While corticosteroids have anti-inflammatory properties, they are not typically used as a first-line treatment for closing a PDA in preterm infants. Surgery (Option D) is considered when medical management such as indomethacin fails to close the PDA or if the infant's condition deteriorates. However, surgery is usually reserved for cases where pharmacological interventions have been ineffective. Educationally, understanding the appropriate treatment for PDA in preterm infants is crucial for pediatric clinical nurse specialists. It is essential to be knowledgeable about the pharmacological options available, their mechanisms of action, and the criteria for selecting the most appropriate treatment based on the infant's condition. This knowledge helps ensure optimal care and outcomes for these vulnerable patients.

Correct Answer: C

Rationale: In this scenario, option C is correct because bleeding from the wound is not related to the choice of naproxen over ibuprofen. The bleeding is likely due to the anticoagulant properties of naproxen itself, not because ibuprofen would have prevented it. Option A is incorrect because the dose of naproxen is within the recommended range for pain control in this patient. Option B is incorrect because while naproxen can increase bleeding risk, it is not a common complication at this dose. Option D is also incorrect as naproxen, like aspirin, can increase bleeding risk, but naproxen is preferred in this case due to its lower association with Reye syndrome compared to aspirin in pediatric patients. Educationally, this question emphasizes the importance of understanding pharmacological effects on patients, especially in pediatric populations. It highlights the need to consider individual patient factors, such as age, underlying conditions, and drug interactions when selecting medications for pain management. It also underscores the significance of monitoring for potential adverse effects and complications post-surgery.

Correct Answer: A

Rationale: The correct answer is A) adolescents. Adolescents are more likely to exhibit more severe violence behavior that can persist into adulthood due to various factors such as hormonal changes, peer influences, and cognitive development. During adolescence, individuals undergo significant emotional and psychological changes, leading to increased risk-taking behaviors, impulsivity, and susceptibility to peer pressure, all of which can contribute to violent behaviors. Option B) school-aged children typically exhibit less severe violence behavior compared to adolescents as they are still developing their social and emotional skills and are more likely to respond to interventions and support. Option C) children of all ages with intermittent violence may display sporadic violent behavior, but it is less likely to be as severe or persistent as in adolescents. Option D) preschoolers are less likely to engage in severe violence behavior that continues into adulthood due to their early stage of development, limited exposure to external influences, and ongoing development of social skills. In an educational context, understanding the developmental stages and risk factors associated with youth violence is crucial for pediatric clinical nurse specialists to identify at-risk individuals, implement appropriate interventions, and collaborate with multidisciplinary teams to address and prevent violence in children and adolescents. By recognizing the subset of children more prone to severe violence behaviors, healthcare professionals can tailor their approaches to provide targeted support and resources for those most in need.

Correct Answer: D

Rationale: The correct answer is D) Hyperglycemia. Systemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects multiple organ systems. Hyperglycemia, which refers to high levels of glucose in the blood, is not a common feature of SLE. A) Malar rash is a common feature of SLE, characterized by a butterfly-shaped rash on the face, typically over the cheeks and bridge of the nose. B) Arthritis is another common feature of SLE, presenting as joint pain, stiffness, and swelling. C) Kidney involvement is also frequently seen in SLE, with manifestations such as lupus nephritis leading to kidney damage. Educationally, understanding the clinical manifestations of SLE is crucial for healthcare providers, especially pediatric clinical nurse specialists who care for children with this condition. By differentiating between common and less common features of SLE, nurses can contribute to early detection, effective management, and improved outcomes for pediatric patients with this complex autoimmune disease.

Correct Answer: D

Rationale: Corticosteroids are commonly prescribed for various pediatric conditions, and long-term use can lead to several complications. The correct answer, option D, "All of the above," is the most appropriate choice as osteoporosis, hypertension, and diabetes mellitus are all common complications associated with long-term corticosteroid use. Osteoporosis is a well-known complication of corticosteroid use due to its negative effects on bone density and mineralization, especially in children whose bones are still developing. This can increase the risk of fractures and musculoskeletal issues. Hypertension can occur as a result of corticosteroids causing sodium retention and fluid imbalance, leading to increased blood pressure. Monitoring blood pressure regularly in pediatric patients on long-term corticosteroids is crucial to detect and manage hypertension promptly. Diabetes mellitus can also develop or worsen with prolonged corticosteroid use due to its impact on glucose metabolism. Children may experience elevated blood sugar levels, insulin resistance, or even steroid-induced diabetes, necessitating close monitoring and potential adjustments in management. In the pediatric clinical setting, understanding these potential complications of corticosteroid therapy is vital for nurses, especially Pediatric Clinical Nurse Specialists. They play a key role in monitoring patients, educating families about side effects, collaborating with the healthcare team to mitigate risks, and ensuring optimal outcomes for pediatric patients requiring long-term corticosteroid treatment. By recognizing and addressing these complications early, nurses can help minimize the impact on the child's health and well-being.