You are meeting parents of a -year-old boy who has normal developmental milestone and social interaction; they have older child with autism; they have a concern about having this young kid with autism as well. You state that most children with autism have clinical manifestations by the age of

Correct Answer: A

Rationale: The correct answer is A) second or third year of life. This is because most children with autism typically start showing clinical manifestations of the condition by this age. It is during the toddler years that parents and healthcare providers may start noticing early signs such as delayed speech or lack of social engagement. Option B) preschool is incorrect because by the time a child reaches preschool age, most children with autism would have already exhibited noticeable symptoms. Option C) school is also incorrect as children with autism typically show signs of the condition much earlier than when they start attending school. Option D) adolescence is not the correct answer because autism is usually diagnosed and identified much earlier in childhood, typically by the age of 2-3 years. Educationally, it is important for pediatric nurses to have a good understanding of the typical developmental milestones and red flags for autism spectrum disorder to provide early intervention and support for children and families. By being knowledgeable about the age at which most children with autism start showing signs, nurses can help parents navigate the diagnostic process and access appropriate resources and services for their child.

Correct Answer: D

Rationale: In this question, the correct answer is D) end abruptly. Conversion reactions in pediatric patients are best characterized by their sudden onset and resolution. These reactions typically manifest as a sudden loss of sensory or motor function, such as paralysis or blindness, with no underlying medical cause. The key characteristic is that these symptoms resolve abruptly and spontaneously, often after a stressful event has passed. Option A) sudden onset is partially correct but does not capture the full picture. While conversion reactions do have a sudden onset, the hallmark feature is actually their abrupt resolution, making option D a more accurate choice. Option B) traceable to a precipitating event is incorrect because conversion reactions often do not have a clear precipitating event. The symptoms may be linked to underlying emotional distress or psychological factors rather than a specific trigger. Option C) involve pseudoseizures is incorrect as pseudoseizures are a specific type of conversion disorder that presents as seizures but without the characteristic electrical discharges seen in epilepsy. Conversion reactions can manifest in various forms beyond pseudoseizures. Educationally, understanding conversion reactions in pediatric patients is crucial for pediatric nurses to provide appropriate care and support. Recognizing the sudden onset and resolution of symptoms can help nurses differentiate between physical and psychological causes, leading to timely interventions and referrals to mental health professionals. This knowledge enhances the holistic care of pediatric patients by addressing their emotional and psychological needs alongside their physical health.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the manifestations of major depression is crucial for early identification and appropriate intervention. The correct answer, D) hypersomnia, is indicative of major depression in children. Children with major depression often experience sleep disturbances, which can present as either insomnia or hypersomnia. In this case, hypersomnia is more commonly associated with pediatric major depression, as children may exhibit excessive daytime sleepiness or increased time spent sleeping. Weight loss (option A) can be a symptom of major depression in some cases, but weight gain (option B) is also a common manifestation, especially in children who may turn to food for comfort. Insomnia (option C) is another possible symptom of major depression, but it is not the defining characteristic. Hypersomnia, on the other hand, is more specific to major depression in children and can significantly impact their daily functioning and quality of life. Educationally, it is important for pediatric nurses to be able to differentiate between the various symptoms of major depression in children to provide accurate assessments and interventions. By understanding the nuanced presentations of major depression, nurses can offer appropriate support and referrals to mental health professionals for further evaluation and treatment. Regular screenings and assessments for mental health concerns, including major depression, should be integrated into pediatric healthcare practices to ensure early detection and intervention for children experiencing mental health challenges.

Correct Answer: D

Rationale: The correct answer is D) massive hemolysis. Explanation: Arsine gas is a highly toxic substance that can cause significant harm to the body. Inhalation of arsine gas can lead to the destruction of red blood cells, a condition known as hemolysis. This process occurs after a latent period of 2-24 hours, where no immediate symptoms are present. Massive hemolysis can result in the release of hemoglobin into the bloodstream, leading to complications such as kidney damage and potentially even death. Why the other options are incorrect: A) Hematuria: While arsine gas exposure can lead to kidney damage, hematuria (blood in the urine) is not a characteristic symptom associated with arsine gas poisoning. B) Sensorimotor peripheral neuropathy: This condition involves damage to the nerves that control movement and sensation in the limbs. While neuropathy can be caused by certain toxins, it is not a typical manifestation of arsine gas exposure. C) Respiratory failure: While arsine gas can cause respiratory symptoms, such as coughing and shortness of breath, respiratory failure is not the primary outcome of arsine gas poisoning. Educational context: Understanding the effects of toxic substances like arsine gas is crucial for healthcare professionals, especially pediatric nurses who may encounter cases of poisoning in children. Recognizing the symptoms and knowing the appropriate treatment measures can help nurses provide timely and effective care to minimize the impact of toxic exposures on pediatric patients. By grasping the specific manifestations of arsine gas poisoning, nurses can contribute to better outcomes and promote the well-being of children under their care.

Correct Answer: A

Rationale: In cases of a potential terrorist attack leading to delayed respiratory symptoms, the empirical administration of an antibiotic effective against anthrax, plague, and tularemia is crucial. The correct choice among the options provided is A) ciprofloxacin. Ciprofloxacin is a broad-spectrum antibiotic that is effective against the pathogens causing anthrax, plague, and tularemia. It is a recommended choice in such scenarios due to its coverage of these potential biothreat agents. Option B) rifampin is not the best choice in this situation as it is not as effective against anthrax, plague, and tularemia compared to ciprofloxacin. Option C) vancomycin is not indicated for the treatment of these specific biothreat agents, making it an incorrect choice. Option D) ampicillin is not effective against anthrax, plague, and tularemia, making it an inappropriate choice for this scenario. In an educational context, understanding the appropriate use of antibiotics in potential biothreat situations is crucial for healthcare professionals, especially for pediatric nurses who may be involved in emergency response scenarios. Knowledge of which antibiotics are effective against specific pathogens is essential for providing timely and effective care to pediatric patients in such critical situations. It highlights the importance of preparedness and the need for healthcare providers to stay informed about bioterrorism threats and appropriate treatment protocols.