Which of the following would the nurse need to keep in mind as a predisposing factor when formulating a teaching plan for a child with a urinary tract infection?

Correct Answer: A

Rationale: In pediatric nursing, it is crucial to consider predisposing factors when formulating a teaching plan for a child with a urinary tract infection (UTI). The correct answer is option A) A shorter urethra in females. This is because anatomically, females have a shorter urethra compared to males, which makes it easier for bacteria to travel up the urinary tract and cause infections. Understanding this anatomical difference is essential for nurses to educate children and their families on proper hygiene practices to prevent UTIs. Option B) Frequent emptying of the bladder is not a predisposing factor for UTIs but rather a preventive measure as it helps flush out bacteria from the urinary tract. Option C) Increased fluid intake is also a preventive measure that helps dilute urine and flush out bacteria but is not a predisposing factor. Option D) Ingestion of acidic juices is not directly related to predisposing factors for UTIs in children. Educationally, understanding the anatomical variances between males and females in terms of urethral length is essential for nurses to provide targeted and effective teaching to prevent UTIs in children. By knowing this predisposing factor, nurses can tailor their education to focus on proper hygiene practices, adequate hydration, and other preventive measures specific to the child's anatomy.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C: A single crease on the palm. This finding, known as a simian crease, can be associated with certain genetic conditions such as Down syndrome. Therefore, it requires further assessment by a healthcare provider to rule out any underlying medical issues and ensure appropriate follow-up care. Option A, many creases across the palm, is a normal finding in a term neonate and does not typically require further assessment. Option B, absence of creases on the palm, is also a normal variation and not a cause for concern. Option D, two large creases across the palm, is not a recognized abnormality that would warrant immediate further assessment. Educationally, understanding the significance of physical examination findings in neonates is crucial for pediatric nursing practice. Recognizing variations from normal can help identify potential health concerns early and ensure appropriate interventions are implemented promptly. It is essential for nurses to be adept at performing thorough assessments and knowing when to escalate concerns for further evaluation by a healthcare provider.

Correct Answer: D

Rationale: In this scenario, option D is the correct answer. The mother's statement about the fontanels being damaged if the molding does not resolve quickly indicates a need for further instruction. This is because cranial molding is a normal process in neonates due to the pressure exerted during birth, and it does not pose a threat to the fontanels. Fontanels are soft spots on a baby's head that allow for brain growth and will not be damaged by cranial molding. Option A is incorrect because cranial molding is not caused by an overriding of cranial bones but rather by the pressure exerted on the baby's head during labor and delivery. Option B is incorrect as the degree of molding is indeed related to the amount of pressure on the head, which is a normal physiological process. Option C is incorrect because while some molding can resolve in a few days, it can take a few weeks for complete resolution in some cases. From an educational perspective, this question highlights the importance of providing accurate and clear information to parents about common neonatal conditions. It emphasizes the role of healthcare providers in educating families to alleviate concerns and promote understanding of normal physiological processes in newborns.

Correct Answer: B

Rationale: In pediatric nursing, administering vaccines correctly is crucial for ensuring the child's safety and efficacy of the immunization. In this scenario, the correct route for administering the DPT vaccine to a two-month-old infant is intramuscular (Option B). The rationale behind this is that intramuscular injections are recommended for vaccines like DPT as they are more effective in eliciting the desired immune response. The muscle tissue allows for better absorption of the vaccine compared to subcutaneous or intradermal routes. Option A, oral administration, is not suitable for the DPT vaccine as it is not designed to be given orally. Option C, subcutaneous, is generally not recommended for DPT vaccine in infants due to potential issues with absorption and efficacy. Option D, intradermal, is also not the preferred route for DPT vaccine in infants. Educationally, understanding the rationale behind choosing the correct route of administration for vaccines is essential for pediatric nurses to ensure they provide safe and effective care to their young patients. It also underscores the importance of following evidence-based practices and recommendations from health authorities regarding vaccine administration in pediatric populations.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the developmental readiness of a child for toilet training is crucial. The correct answer, "D) The child is not developmentally ready to be trained," is supported by child development theories and milestones. At around 2 years of age, children may not have the necessary physical, cognitive, and emotional maturity to successfully engage in toilet training. This can lead to frustration, setbacks, and ultimately failure if pushed prematurely. Option A, "Rewards are too limited," is incorrect because while positive reinforcement is important in toilet training, the primary factor is the child's readiness. Option B, "Training equipment is inappropriate," is not the main reason for failure; it may affect comfort but not readiness. Option C, "Parents ignore 'accidents' that occur during training," is also not the primary reason; accidents are common during training and should be handled positively. Educationally, nurses must educate parents about recognizing signs of readiness in their child, such as showing interest, staying dry for longer periods, and following simple instructions. Understanding these aspects can help parents set realistic expectations and approach toilet training with patience and understanding, ultimately leading to more successful outcomes.