Which should NOT raise suspicion of autistic spectrum disorders?

Correct Answer: D

Rationale: In pediatric nursing, it is essential to recognize early signs of developmental disorders like autism spectrum disorders (ASD) to provide timely interventions and support. In this context, understanding the indicators that should raise suspicion of ASD is crucial for healthcare professionals working with children and their families. The correct answer, D) Pediatrician concern, is the least likely to raise suspicion of ASD among the options provided. This is because pediatricians are trained to assess child development comprehensively and may have a broader perspective when evaluating a child's behavior and milestones. Therefore, if a pediatrician does not express concerns about ASD after a thorough evaluation, it is less likely that the child has the disorder. A) Sibling with ASD may raise suspicion of ASD due to a genetic predisposition and shared environmental factors within the family. B) Playmate concern could indicate social difficulties or atypical behaviors observed by peers, which are common in children with ASD. C) Parental concern is also significant as parents are usually the first to notice unusual behaviors or delays in their child's development. Educationally, understanding these nuances in red flag indicators for ASD can help pediatric nurses and healthcare providers make informed assessments and referrals for further evaluation. It highlights the importance of interdisciplinary collaboration and considering multiple perspectives when evaluating a child for developmental concerns, ultimately leading to better outcomes for children and their families.

Correct Answer: C

Rationale: Breath-holding spells are best described as an expression of frustration or anger (Option C). These spells are typically involuntary and are triggered by a child's response to a stressful or upsetting situation. It is crucial for healthcare professionals, like nurses, to understand that breath-holding spells are not a manifestation of iron deficiency anemia (Option A), a type of seizure (Option B), or a problem that only manifests when the child becomes older (Option D). Understanding breath-holding spells is essential in pediatric nursing as they can be alarming for caregivers and may lead to unnecessary interventions if not properly recognized. By recognizing that these spells are often a response to emotional triggers rather than a medical issue, nurses can provide appropriate support and education to parents and caregivers on how to manage these episodes effectively. Educationally, nurses need to be equipped with knowledge about various pediatric conditions, including non-life-threatening phenomena like breath-holding spells. This empowers them to deliver holistic care, address parental concerns, and promote positive outcomes for pediatric patients. By choosing Option C as the correct answer, nurses can enhance their understanding of child development and behavior, leading to improved patient care and family support.

Correct Answer: D

Rationale: In this question, the correct answer is D) truancy. Truancy is not a recognized characteristic of autism spectrum disorder (ASD). A) The presence of 3 grades of severity is a recognized feature of ASD, with individuals falling along a spectrum that ranges from mild to severe in terms of symptoms and impairments. B) While individuals with ASD may struggle with certain social and communication skills, they may exhibit superior intellectual functioning in specific areas, such as math or music. This is known as "splinter skills" or "islets of ability". C) Motor deficits are commonly seen in individuals with ASD, including challenges with coordination, motor planning, and fine motor skills. Educational context: Understanding the characteristics of ASD is crucial for pediatric nurses as they may encounter children with this condition in their practice. By recognizing the features of ASD, nurses can provide appropriate care and support to these individuals and their families. Truancy, which is not a recognized feature of ASD, should not be assumed to be related to the condition without further assessment and consideration of other factors.

Correct Answer: D

Rationale: In pediatric nursing, understanding the causes of generalized edema in newborns is crucial for accurate assessment and intervention. In this scenario, the correct answer is D) Hurler syndrome. Hurler syndrome is a rare genetic disorder characterized by the accumulation of glycosaminoglycans in various tissues, leading to organ and tissue damage. This accumulation can result in generalized edema in newborns affected by this syndrome. Prematurity (option A) can also lead to generalized edema in newborns due to immature organ function, especially the kidneys, which may have difficulty regulating fluid balance. Nonimmune hydrops (option B) is characterized by abnormal fluid accumulation in fetal compartments and can result in generalized edema at birth. Turner syndrome (option C) is a genetic condition that can present with lymphedema or swelling due to a buildup of lymph fluid. Educationally, understanding the differential diagnoses of generalized edema in newborns is essential for nurses to provide comprehensive care. By recognizing the unique presentations of various conditions, nurses can facilitate early identification, appropriate management, and family support. Remembering the specific association of Hurler syndrome with generalized edema can aid in timely referrals and interventions to improve outcomes for affected newborns.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding multiple gestation pregnancies is crucial for providing comprehensive care to mothers and infants. In this question, option D is the correct answer because stating that "the overall incidence of multifetal gestation is unchanged" is incorrect. The incidence of multifetal gestation has been increasing due to factors like advanced maternal age and assisted reproductive technologies. Option A is incorrect because the reported incidence of spontaneous twinning is actually highest in the African races, not lowest in Asian races. Option B is incorrect as the estimated occurrence of triplets is 1 in 8,100 pregnancies in the USA, not 1 in 86². Option C is incorrect because the incidence of monozygotic twins can be influenced by factors such as assisted reproductive technologies and genetic predisposition. Educationally, this question highlights the importance of accurate knowledge in pediatric nursing, especially concerning high-risk pregnancies. Nurses need to be well-versed in the latest data and trends to provide evidence-based care to mothers and infants during pregnancy, delivery, and postpartum periods, particularly in cases of multiple gestation pregnancies. Understanding these nuances helps nurses deliver safe and effective care to ensure optimal outcomes for both the mother and her infants.