Pediatric Research Questions

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A patient with a history of endocarditis is undergoing a bowel resection. The nurse explains that the prophylactic antibiotics prevent which of the following?

  • A. Endocarditis c.Vegetative emboli
  • B. Peritonitis
  • C. Inflammation
Correct Answer: A

Rationale: Prophylactic antibiotics are given to prevent the recurrence or complications of endocarditis in patients with a history of the condition. Endocarditis is an infection of the inner lining of the heart chambers and valves. One of the serious complications of endocarditis is the formation of vegetative emboli, which are clusters of bacteria and fibrin that can break off and travel through the bloodstream, potentially causing blockages in various organs. By preventing endocarditis, the antibiotics also help reduce the risk of vegetative emboli formation during surgical procedures or other situations where bacteria may enter the bloodstream. Therefore, the nurse's explanation to the patient about the prophylactic antibiotics is focused on preventing complications related to endocarditis, including the formation of vegetative emboli.

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Daya's child is scheduled for surgerydue to myelomeningocele; the primary reason for surgical repair is which of thefollowing?

  • A. To prevent hydrocephalus
  • B. To reduce the risk of infection
  • C. To correct the neurologic defect
  • D. To prevent seizure disorders
Correct Answer: C

Rationale: The primary reason for surgical repair of myelomeningocele is to correct the neurologic defect caused by this type of birth defect. Myelomeningocele is a form of spina bifida where the spinal cord and its covering are exposed through an opening in the spine. Surgical closure of the defect is performed to protect the spinal cord and nerves, prevent further damage, and potentially improve long-term outcomes for the child. While preventing complications like hydrocephalus or infection may be important secondary goals of the treatment, the main objective of surgery for myelomeningocele is to address the underlying neurologic defect itself.

Which manifestation suggests that an infant is developing necrotizing enterocolitis (NEC)?

  • A. Faster absorption of orogastric feedings.
  • B. Bloody diarrhea.
  • C. Increased bowel sounds.
  • D. Hunger before feeding.
Correct Answer: B

Rationale: Bloody diarrhea is a key sign of NEC, indicating intestinal injury.

Cherry, the mother of an 11-month-old girl, Elizabeth, is in the clinic for her daughter's immunizations. She expresses concern to the nurse that Elizabeth cannot yet walk. The nurse correctly replies that, according to the Denver Developmental Screen, the median age for walking is:

  • A. 12 months.
  • B. 15 months.
  • C. 10 months.
  • D. 14 months.
Correct Answer: A

Rationale: The Denver Developmental Screening Test states that the median age for walking is around 12 months. This means that about half of all typically developing children will begin to walk by this age. It is important to note that there is a wide range of normal development, and not all children will hit these milestones at the same time. If Cherry's 11-month-old daughter, Elizabeth, is not yet walking, it does not necessarily indicate a developmental delay as long as she is meeting other milestones within a reasonable timeframe.

A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The physician begins the client on cyanocobalamin (Betalin-12), 100mcg IM daily. Which substance influences Vitamin B12 absorption?

  • A. Intrinsic factor
  • B. Histamine
  • C. Hydrochloric acid
  • D. Liver enzyme
Correct Answer: A

Rationale: Intrinsic factor is a glycoprotein produced by the parietal cells of the stomach. It is essential for the absorption of vitamin B12 in the intestine. Vitamin B12 binds to intrinsic factor in the stomach, forming a complex that is absorbed in the ileum of the small intestine. Without intrinsic factor, vitamin B12 absorption is significantly impaired, leading to conditions like pernicious anemia, which is a type of megaloblastic anemia caused by vitamin B12 deficiency. By administering cyanocobalamin (Betalin-12) intramuscularly, the need for intrinsic factor in the absorption process is bypassed, which is necessary in cases where intrinsic factor production or function is disrupted.

A female child, age 2, is brought to the emergency department after ingesting an unknown number of aspirin tablets about 30 minutes earlier. On entering the examination room, the child is crying and clinging to the mother. Which data should the nurse obtain first?

  • A. Heart rate, respiratory rate, and bloodpressure
  • B. Recent exposure to communicable diseases
  • C. Number of immunizations received
  • D. Height and weight
Correct Answer: A

Rationale: In this situation, the priority data the nurse should obtain first is the vital signs including heart rate, respiratory rate, and blood pressure of the child. This information will help assess the child's current physiological status and potential effects of ingesting the aspirin. Aspirin overdose in children can lead to serious complications such as metabolic acidosis, respiratory distress, and cardiovascular instability. Monitoring the vital signs will provide crucial information to guide appropriate interventions and determine the severity of the child's condition. Height and weight (option D) are important for routine assessments but not the priority in this urgent situation. Recent exposure to communicable diseases (option B) and number of immunizations received (option C) are not relevant to the immediate management of the child's aspirin ingestion.

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