You are a newly employed Pediatrician to foster care children. Those children have many significant problems, but the MOST common one is

Correct Answer: B

Rationale: In the context of caring for foster care children as a pediatrician, the most common significant problem is abuse and neglect (Option B). This is because children in foster care often come from backgrounds where they have experienced trauma, abuse, or neglect, which can have profound impacts on their physical, emotional, and mental well-being. Abuse and neglect are pervasive issues in the lives of many foster care children, leading to a range of health problems, developmental delays, behavioral issues, and emotional challenges. As a pediatrician, it is crucial to be aware of and vigilant for signs of abuse and neglect in these vulnerable children to ensure their safety and well-being. Regarding the other options: - Chronic medical problems (Option A) may be prevalent in some foster care children, but they are not as universally common or pervasive as the effects of abuse and neglect. - Mental health concerns (Option C) are indeed significant in this population, but often stem from the trauma of abuse and neglect. - Family relationship problems (Option D) can be a consequence of abuse and neglect but are not as consistently the primary issue as the abuse and neglect itself. Educationally, understanding the prevalence and impact of abuse and neglect on foster care children is crucial for healthcare providers working with this population. By recognizing the primary challenges these children face, healthcare professionals can better advocate for their needs, provide appropriate interventions, and work towards improving their overall health and well-being.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding jaundice in infants is crucial. The correct answer, option B, indicates physiologic jaundice in a term infant. Physiologic jaundice typically presents within the first 24 hours post-birth and resolves by the first week. The key characteristic is a gradual increase in serum bilirubin levels of less than 5 mg/dL per day. This pattern is considered normal as it results from the breakdown of fetal red blood cells and the immature liver's ability to process bilirubin efficiently. Option A is incorrect because jaundice within the first 24 hours is more likely to be pathological. Option C is incorrect as a high direct serum bilirubin level suggests a pathologic cause such as biliary atresia. Option D is incorrect as jaundice appearing after the first week raises concern for pathological jaundice and further investigation is warranted. Educationally, recognizing the characteristics of physiologic jaundice is vital for pediatric nurses to differentiate normal variations from potentially serious conditions. Understanding the timing, rate of rise in bilirubin levels, and associated factors can guide appropriate interventions and prevent unnecessary anxiety for caregivers. This knowledge ensures safe and effective care for neonates experiencing jaundice.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Intravenous ampicillin and gentamicin. This treatment is appropriate because the infant is showing signs of respiratory distress and sepsis, which are common complications associated with premature rupture of membranes. Ampicillin and gentamicin are broad-spectrum antibiotics that cover a wide range of potential pathogens that could be causing the sepsis. Option A) Surfactant by aerosol is not the most appropriate choice in this case as the primary issue is likely related to infection rather than respiratory distress syndrome. Option C) Intravenous steroids would not be the first-line treatment in this situation. Steroids are typically used to help with lung development in premature infants at risk for respiratory distress syndrome but are not indicated for the immediate management of sepsis. Option D) Intravenous acyclovir is used to treat viral infections, particularly herpes infections. Since there is no indication of a viral infection in this case, acyclovir would not be the most appropriate treatment. Educationally, this question highlights the importance of recognizing and managing complications in premature infants, such as sepsis, which can quickly become life-threatening. Understanding the appropriate use of antibiotics in neonatal care is crucial for pediatric nurses to provide safe and effective care to this vulnerable population.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Pneumothorax. When a preterm infant is born, especially at 7 weeks' gestation, their lungs are underdeveloped and fragile, making them susceptible to conditions like pneumothorax, which is the accumulation of air in the pleural space causing lung collapse. This condition can lead to respiratory distress due to compromised lung function. Option B) Respiratory distress syndrome (RDS) is a common condition in preterm infants where the lungs lack surfactant, leading to difficulty in breathing. While RDS is a possible cause of respiratory distress in preterm infants, in this case, the presentation is more indicative of pneumothorax. Option C) Patent ductus arteriosus is a heart condition where a blood vessel fails to close after birth, causing circulation issues. While this can lead to respiratory distress in some cases, it is less likely in this scenario compared to pneumothorax. Option D) Group B streptococcal sepsis is a bacterial infection that can affect newborns, but it typically presents with symptoms like fever, lethargy, poor feeding, and respiratory distress may not be the primary symptom, making it less likely in this case. Educationally, understanding the common complications and conditions in preterm infants is crucial for pediatric nurses to provide prompt and effective care. Knowing the specific signs and symptoms of conditions like pneumothorax can help nurses intervene quickly and improve outcomes for these vulnerable patients.

Correct Answer: B

Rationale: Polycythemia is a condition characterized by an excess of red blood cells in the blood. The correct answer, option B, "Intrauterine growth retardation," is not typically associated with polycythemia. In polycythemia, the body produces too many red blood cells, leading to hyperviscosity of blood (option A), which can impact circulation and organ function. Large-for-gestational-age infants (option C) may be associated with maternal diabetes rather than polycythemia. Twin-twin transfusion syndrome (option D) occurs in identical twins sharing a placenta, leading to imbalanced blood flow between the fetuses, but it is not directly related to polycythemia. In an educational context, understanding the associations of polycythemia is crucial for pediatric nurses caring for infants at risk for this condition. Recognizing the signs and symptoms of polycythemia, such as hyperviscosity, helps nurses provide appropriate interventions and prevent complications. By knowing the correct associations and understanding why certain conditions are not linked to polycythemia, nurses can deliver high-quality care to pediatric patients effectively.