A 12-year-old boy with no history of trauma or emotional problems recently began screaming and crying out at night. He does not fully wake up after these episodes, and he has little to no recall as to what he was dreaming about. Which of the following diagnoses is most likely in this scenario?
Nightmare disorder
Sleep terrors
Insomnia
REM sleep behavior disorder
The Correct Answer is B
Choice A reason: Nightmare disorder involves vivid, frightening dreams that occur during REM sleep and typically awaken the child, who can recall the dream content. In this case, the child does not fully wake and has no memory of the episode, which is inconsistent with nightmare disorder.
Choice B reason: Sleep terrors, also known as night terrors, are episodes of intense fear, screaming, and autonomic arousal that occur during non-REM sleep, usually within the first few hours of sleep. Children experiencing sleep terrors are difficult to awaken, appear confused, and typically have no memory of the event. This matches the boy’s presentation precisely.
Choice C reason: Insomnia is characterized by difficulty initiating or maintaining sleep, or waking too early. It does not involve screaming, crying, or episodes of confusion during sleep. The boy’s symptoms are not consistent with insomnia.
Choice D reason: REM sleep behavior disorder involves physically acting out dreams due to loss of normal REM atonia. It is more common in older adults and involves purposeful movements rather than screaming or crying. The child’s age and presentation make this diagnosis unlikely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: While some mild viral pneumonias may resolve without antibiotics, bacterial CAP in children typically requires treatment. Delaying therapy can lead to complications such as empyema or respiratory failure.
Choice B reason: Macrolides (e.g., azithromycin) are effective against atypical pathogens like Mycoplasma pneumoniae, which are more common in older children and adolescents. However, in younger children, typical bacterial pathogens like Streptococcus pneumoniae are more prevalent, making macrolides less ideal as first-line therapy.
Choice C reason: Beta lactam antibiotics, such as amoxicillin, are the first-line treatment for CAP in children due to their efficacy against Streptococcus pneumoniae, the most common bacterial cause. They are well tolerated and widely recommended in pediatric guidelines.
Choice D reason: Cephalosporins may be used in cases of beta-lactam allergy or severe infection requiring hospitalization, but they are not typically first-line for uncomplicated CAP in otherwise healthy children.
Correct Answer is D
Explanation
Choice A reason: This describes the pathophysiology of gastroesophageal reflux disease (GERD), not ulcerative colitis. UC affects the colon, not the esophagus.
Choice B reason: This explanation pertains to peptic ulcer disease, where H. pylori and NSAIDs disrupt gastric mucosal defenses. It does not apply to UC, which is an inflammatory bowel disease.
Choice C reason: These factors may influence general gastrointestinal health or contribute to irritable bowel syndrome (IBS), but they do not explain the autoimmune and inflammatory nature of UC.
Choice D reason: Ulcerative colitis is characterized by chronic inflammation of the colon due to defects in the epithelial barrier, dysregulated immune responses, abnormal leukocyte trafficking, and altered gut microbiota. These mechanisms lead to mucosal ulceration, bleeding, and systemic symptoms.
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