You are following a 6-year-old boy with autism, he is under structured psychosocial behavioral training program, there is frequent complains of aggression and self-injurious behavior. Of the following, the BEST medication to control his behavior is

Correct Answer: B

Rationale: In managing behavioral challenges in children with autism, the use of atypical antipsychotics like risperidone has been found to be effective. Risperidone is the best choice among the options provided due to its proven efficacy in reducing aggression and self-injurious behaviors in children with autism spectrum disorder. It acts by blocking dopamine and serotonin receptors, helping to regulate mood and behavior. Methylphenidate (Option A) is a stimulant commonly used for ADHD, not for managing aggression in autism. Escitalopram (Option C) is a selective serotonin reuptake inhibitor used for anxiety and depression, not for behavior control. Atomoxetine (Option D) is a non-stimulant used for ADHD, not typically for aggression in autism. Educationally, understanding the rationale behind the use of specific medications in pediatric patients with autism is crucial for nurses caring for these individuals. It is important to be aware of the most effective pharmacological interventions to provide safe and optimal care for children with autism spectrum disorder. Additionally, being knowledgeable about the side effects and monitoring requirements of medications like risperidone is essential for patient safety and well-being.

Correct Answer: A

Rationale: In the context of pediatric nursing, understanding the etiology of seizures in neonates is crucial for timely and appropriate intervention. In this scenario, the correct answer is A) hypoxic-ischemic encephalopathy. When a newborn experiences a lack of oxygen and blood flow to the brain during birth or shortly thereafter, it can result in brain injury leading to seizures. This condition is a common cause of neonatal seizures, making option A the correct choice. Option B) unintentional injection of maternal local anesthetic into the fetus is unlikely to cause seizures in the neonate as local anesthetics have a minimal effect on the central nervous system of the fetus. Option C) intracranial hemorrhage may cause seizures in neonates, but typically the onset would be delayed rather than immediately after birth. Option D) hypoglycemia is another potential cause of seizures in neonates, but seizures related to hypoglycemia usually occur later in the neonatal period rather than immediately after birth. Educationally, this question highlights the importance of recognizing common causes of neonatal seizures, such as hypoxic-ischemic encephalopathy, and underscores the need for prompt assessment and intervention in neonatal care to prevent adverse outcomes related to seizures and underlying conditions. Nurses caring for neonates must be knowledgeable about the various causes of seizures and be prepared to respond swiftly to provide optimal care for these vulnerable patients.

Correct Answer: B

Rationale: In the context of pediatric nursing, the administration of antenatal corticosteroids to women between 24 and 34 weeks of gestation is a crucial intervention aimed at promoting fetal lung maturity and reducing the incidence and severity of respiratory distress syndrome (RDS) in premature infants. The correct answer, B) postnatal growth, is the exception because antenatal corticosteroids primarily impact lung development and function rather than postnatal growth parameters. The administration of corticosteroids does not directly influence postnatal growth outcomes in premature infants. Option A) incidence and mortality of RDS is impacted positively by antenatal corticosteroids as they aid in reducing respiratory complications. Option C) the overall neonatal mortality is reduced as a result of decreased incidence of RDS and other complications. Option D) need for and duration of ventilatory support is also decreased due to the improved lung function resulting from antenatal corticosteroid administration. In an educational context, understanding the rationale behind administering antenatal corticosteroids can help pediatric nursing students grasp the importance of evidence-based interventions in improving neonatal outcomes. It underscores the significance of this intervention in reducing respiratory morbidity and mortality in preterm infants, thereby emphasizing the holistic care approach in neonatal nursing practice.

Correct Answer: A

Rationale: In pediatric nursing, understanding predisposing factors for conditions like persistent pulmonary hypertension of the newborn (PPHN) is crucial for providing effective care. In this case, the correct answer is option A) anemia. Anemia is not a typical predisposing factor for PPHN. PPHN is primarily associated with respiratory distress, and factors such as meconium aspiration syndrome, early-onset sepsis, and birth asphyxia are more commonly linked to this condition. Meconium aspiration syndrome occurs when a newborn inhales meconium-stained amniotic fluid, leading to respiratory issues. Early-onset sepsis can cause systemic inflammation, affecting the pulmonary vasculature. Birth asphyxia, which involves oxygen deprivation during birth, can impact lung function and contribute to PPHN. Understanding these predisposing factors is crucial for nurses caring for newborns at risk for PPHN. By recognizing these associations, nurses can provide early interventions, closely monitor at-risk infants, and collaborate with the healthcare team to optimize outcomes for these vulnerable patients. This knowledge underscores the importance of thorough assessment, prompt recognition of risk factors, and timely interventions in pediatric nursing practice.

Correct Answer: D

Rationale: Breast milk jaundice is a common condition in newborns, characterized by elevated levels of unconjugated bilirubin in breastfed infants. The correct answer, D) kernicterus never occurs, is true because breast milk jaundice, although it can cause prolonged jaundice, does not lead to kernicterus, a severe neurological condition resulting from high bilirubin levels. Option A) is incorrect because breast milk jaundice develops in around 2% of breastfed term infants, making it a common occurrence. Option B) is incorrect as maximal unconjugated bilirubin concentrations as high as 10-30 mg/dL can indeed be reached during the 2nd-3rd week in breast milk jaundice. Option C) is also incorrect as jaundice in breast milk jaundice can persist for 3-10 weeks, contributing to parental concerns and the necessity for monitoring. From an educational standpoint, understanding breast milk jaundice is crucial for pediatric nurses to provide proper care and education to parents. Differentiating breast milk jaundice from pathological jaundice is vital to avoid unnecessary interventions. Nurses should educate parents on monitoring jaundice, feeding practices, and when to seek medical attention if the jaundice persists or worsens.