A. Typically, infants are kept NPO for 1-2 hours before a lumbar puncture, not 6 hours.

B. Holding the infant’s chin to the chest and knees to the abdomen during the lumbar puncture is the correct positioning. This position opens the intervertebral spaces and allows for easier access to the spinal cord.

C. Eutectic mixture of lidocaine and prilocaine (EMLA) cream should be applied 60 minutes before the procedure for effective local anesthesia, not 15 minutes.

D. After the procedure, the infant should be placed flat to avoid pressure on the lumbar area, not in an infant seat. The infant should be positioned on their back or side to prevent strain.

A. Pulmonary stenosis is one of the characteristic features of TOF, causing obstruction to blood flow to the lungs.
B. Overriding aorta is a defining feature of TOF, where the aorta is positioned over the ventricular septal defect, leading to mixing of oxygenated and deoxygenated blood.
C. Right ventricular hypertrophy occurs in TOF due to increased workload on the right ventricle caused by pulmonary stenosis.
D. Coarctation of the aorta is not part of Tetralogy of Fallot; it is a separate congenital defect.
E. A ventricular septal defect is the hole between the ventricles in TOF, leading to the mixing of oxygenated and deoxygenated blood.

A. A pacifier should not be offered after cleft lip surgery, as it can put pressure on the surgical site and affect healing.
B. Rocking the infant can be a soothing and comforting action to help the infant recover from surgery. It provides emotional comfort and promotes bonding with the parents.
C. Ibuprofen is generally not recommended for infants under 6 months of age unless prescribed by the provider. Appropriate pain management should be used based on the infant's age and condition.
D. Positioning the infant on her abdomen is not appropriate after cleft lip surgery, as this could place pressure on the surgical area. The infant should be positioned on her back or side to avoid stress on the repair site.

A. While methicillin resistance is a concern, it does not pose an immediate threat to the child’s life compared to the risk of sepsis.
B. Redness in the affected area is a typical symptom of cellulitis and, while it should be monitored, it is not the most urgent concern.
C. The risk for recurrence is important for long-term management but is not the primary concern in the acute phase of cellulitis.
D. Sepsis is the most immediate concern in cellulitis because the infection can rapidly spread into the bloodstream, leading to systemic infection and potential life-threatening complications.

A. Clinicians should be involved in discussions about the child’s prognosis to ensure that the family receives clear, compassionate information for decision-making.

B. Palliative care can and should be introduced earlier in the course of the illness, not just when the child is expected to live less than 6 months.

C. Parents expressing hope for survival do not necessarily reject palliative care. Palliative care can focus on comfort and quality of life even when there is still hope for recovery.

D. Palliative care should be integrated with curative care, as it can improve the quality of life while still pursuing treatment options.

A. Concrete thinking occurs during the concrete operational stage (7-11 years old), where children focus on tangible, real-world situations.

B. Egocentric thinking is characteristic of the preoperational stage (2-7 years old) and is when children have difficulty understanding others’ perspectives.

C. Abstract thinking occurs during adolescence and allows individuals to think hypothetically, reason logically, and understand complex concepts that are not tied to concrete experiences.

D. Preoperational thinking occurs in early childhood (2-7 years old), which is characterized by limited logic and the inability to think abstractly.

A. Tracheoesophageal fistula involves an abnormal connection between the esophagus and trachea, typically presenting with respiratory distress, coughing, and feeding difficulties, not a palpable abdominal mass and blood in stools.

B. Hypertrophic pyloric stenosis is characterized by projectile vomiting, dehydration, and an olive-shaped mass in the upper abdomen, not blood and mucus in the stools.

C. Inguinal hernia may present with a bulging mass in the groin area, but it does not cause blood or mucus in stools.

D. Intussusception is characterized by the telescoping of one part of the intestine into another, which can cause a palpable mass, abdominal pain, and stools mixed with blood and mucus (often referred to as "currant jelly" stools).

A. Hypotension is the most critical finding in dehydration, as it indicates severe fluid loss and can lead to shock. Immediate intervention is required to address the circulatory compromise.

B. Tachypnea is a compensatory response to dehydration and may not require as immediate attention as hypotension.

C. Hyperpyrexia (high fever) can occur in gastroenteritis but is less urgent compared to hypotension.

D. Skin breakdown is a concern in dehydrated patients, but hypotension poses a more immediate threat to life.

A. Encouraging large amounts of fluids may not be effective in preventing nausea and vomiting and can worsen dehydration if the child is unable to keep fluids down.

B. Administering an antiemetic 30 minutes to 1 hour before chemotherapy is the most effective strategy for preventing nausea and vomiting. This proactive approach helps to prevent the symptoms before they occur.

C. NPO until symptoms subside is not appropriate because it can lead to dehydration and malnutrition.

D. Administering an antiemetic after symptoms begin is reactive rather than proactive, and it is more effective to prevent symptoms from occurring.

A. "I am going to listen to your heart" is the most appropriate way to introduce the process of taking vital signs, as it is non-threatening and familiar to the child.

B. "Can you stand still while I feel how warm you are?" may be confusing to a toddler, as they might not understand what "feeling warm" means.

C. "Can I listen to your lungs?" might sound unfamiliar or intimidating to a toddler.

D. "Can I take your blood pressure now?" is a more advanced procedure that may cause anxiety and should be introduced after explaining the other vital signs.