Pediatric Nursing

Why C is correct

Hemophilia A is a lack of clotting factor VIII, so an active bleed is treated by replacing factor VIII promptly. Each form of hemophilia is named for the one factor it lacks, and the product given must be that same factor.

Why the other options are wrong

• A — "Factor IX concentrate": Factor IX concentrate is the correct product for hemophilia B, but this boy's disease lacks factor VIII instead.
• B — "Vitamin K": Vitamin K restores factors II, VII, IX and X, and factor VIII is not among them.
• D — "Platelet concentrate": Platelets help when the platelet count is low, but a platelet unit does not supply the factor VIII this boy lacks.

Why C is correct

Draw up two injections: a second injectable polio dose falls at nine months.

The program gives the oral drops three times in infancy and the injectable polio vaccine twice, at fourteen weeks and again at nine months.

Why the other options are wrong

• A — "The polio series finished with the oral drops, so no polio dose is due": the drops are a genuine part of the series, but the injectable vaccine runs its own two-dose schedule beside them.
• B — "A booster of the five-in-one vaccine is given alongside the measles dose today": the combined infant vaccine has no booster at this age.
• D — "The tuberculosis vaccine is repeated now": there is no indication to repeat the dose at this visit.

Why C is correct

In cystic fibrosis, an inherited disease that thickens mucus, the sweat glands make extra-salty sweat. Heavy sweating in the heat can then drain the body's salt quickly, a salt loss that leaves a toddler weak and listless.

Why the other options are wrong

• A — "Low blood sugar from eating less during play": Low blood sugar can make a tired toddler sluggish, but it does not explain why heavy sweating is the danger in this disease.
• B — "Carbon dioxide build-up from a flare of lung disease": Carbon dioxide build-up comes with worsening lung disease, not with a day of sweating in the heat.
• D — "Dehydration from ordinary water loss in the heat": Dehydration is a genuine part of this picture, but in cystic fibrosis the sweat is extra salty, so the salt lost outruns the water lost.

Why B is correct

Injections of man-made growth hormone can help a child with chronic kidney disease reach a normal height. This growth hormone therapy acts like the body's own hormone. Chronic kidney disease is kidney damage that develops slowly over months to years. Wastes that build up in his blood weaken the effect of his own growth hormone.

Why the other options are wrong

• A — "A daily multivitamin with minerals bought over the counter": Store-bought vitamin and mineral tablets may harm children with kidney failure; his kidney specialist prescribes any he needs.
• C — "Protein drinks added on top of his meal plan": Extra protein drinks would take him past his meal plan. Protein plays a role in growth, but protein beyond his plan leaves waste in the blood that his kidneys must clear.
• D — "Thyroid hormone tablets taken each morning": Thyroid hormone replaces what an underactive thyroid fails to make; nothing here points to thyroid disease.

Why B is correct

Menarche is a girl's first period. In the first year after it, irregular cycles are a normal part of puberty. The hormone system linking the brain and ovaries is still maturing, and many cycles release no egg.

Why the other options are wrong

• A — "Her cycles should already follow a regular monthly pattern by now": A young teen's cycles may not match an adult's for some years after menarche.
• C — "Her irregular cycles point to polycystic ovary syndrome and need checking": Polycystic ovary syndrome is a hormone condition with irregular periods and excess male hormones. It is a genuine cause of irregular cycles, but cycles in the first year after menarche do not count toward it.
• D — "Her irregular cycles call for a pelvic ultrasound of her ovaries": Guidelines advise against pelvic ultrasound to diagnose polycystic ovary syndrome until eight years after menarche.