Pediatric Nursing Exam Preparation -Nurselytic

Correct Answer: specifically a hemolytic reaction. A hemolytic reaction occurs when there is a serious incompatibility between the patient's blood type and the transfused blood

Rationale: In this scenario, the correct response is option
C) Stop the transfusion or call the RN STAT depending on agency policy. This is the appropriate action to take because chest and back pain during a transfusion of packed RBC can be indicative of a hemolytic reaction. A hemolytic reaction is a severe transfusion reaction that occurs when there is a major incompatibility between the patient's blood type and the transfused blood. It can lead to serious complications such as kidney damage, shock, and even death if not promptly addressed.

Option
A) Do a complete physical assessment, and option
B) Ask the patient to rate his pain on a 0 to 10 scale, are not the most immediate actions to be taken in this situation. While a physical assessment is important, stopping the transfusion takes precedence in the case of a potential transfusion reaction. Asking the patient to rate his pain can provide some information but does not address the urgency of the situation.

Option
D) Administer his analgesic, PRN, is incorrect because administering analgesics without addressing the potential underlying cause of the pain can mask symptoms and delay appropriate intervention for the transfusion reaction.

In an educational context, it is crucial for nursing students to understand the signs and symptoms of transfusion reactions, including hemolytic reactions, and the appropriate steps to take in such emergencies to ensure patient safety and well-being. Prompt recognition and response to adverse events during transfusion therapy are essential skills for nurses caring for pediatric patients.

Correct Answer: D

Rationale: In the context of Pediatric Nursing and Rheumatoid Arthritis, the correct answer is
D) All of the above. This is because Rheumatoid Arthritis is associated with the presence of multiple antibodies, not just one.


A) Anti-CCP (Cyclic Citrullinated Peptide) is a specific antibody that is highly specific for Rheumatoid Arthritis and is often used in its diagnosis.


B) ANA (Antinuclear Antibody) is not primarily associated with Rheumatoid Arthritis but is rather more commonly linked to autoimmune conditions like Systemic Lupus Erythematosus.


C) RF (Rheumatoid Factor) is another antibody commonly found in Rheumatoid Arthritis patients, although its presence is not exclusive to this condition.

Educationally, understanding the specific antibodies associated with Rheumatoid Arthritis is crucial for nurses caring for pediatric patients with this condition. Recognizing these antibodies helps in early diagnosis, appropriate treatment initiation, and monitoring disease progression. It also aids in differentiating Rheumatoid Arthritis from other autoimmune disorders with similar presentations, enhancing the quality of care provided to pediatric patients.

Correct Answer: D

Rationale: In the treatment of rheumatic diseases, hydroxychloroquine plays a multifaceted role, making option D, "All of the above," the correct answer.


A) Suppress immune response: Hydroxychloroquine is an immunomodulatory drug that can suppress an overactive immune response, which is often seen in rheumatic diseases like lupus and rheumatoid arthritis. By modulating the immune system, hydroxychloroquine helps in controlling autoimmune reactions and reducing disease activity.


B) Reduce inflammation: Hydroxychloroquine has anti-inflammatory properties that can help reduce inflammation in joints, skin, and other affected tissues in rheumatic diseases. By decreasing inflammation, it can alleviate pain, swelling, and stiffness associated with these conditions.


C) Improve skin lesions: In conditions like lupus, hydroxychloroquine is known to improve skin lesions, including rashes and discoid lesions. Its anti-inflammatory and immunomodulatory effects can help in managing skin manifestations of rheumatic diseases.

Educational context: Understanding the role of hydroxychloroquine in treating rheumatic diseases is crucial for healthcare professionals, especially pediatric nurses, who may encounter children with these conditions. By knowing how hydroxychloroquine works, nurses can effectively monitor for drug efficacy and potential side effects, educate patients and families on medication management, and collaborate with the healthcare team to optimize treatment outcomes for pediatric patients with rheumatic diseases.

Correct Answer: A

Rationale: In pediatric nursing, understanding systemic sclerosis and its characteristic features is crucial for providing effective care. The correct answer is
A) Raynaud's phenomenon. This is a key feature of systemic sclerosis, characterized by the narrowing of blood vessels in response to cold or stress, leading to color changes in the fingers and toes.

Option
B) Joint swelling is more commonly seen in conditions like juvenile idiopathic arthritis rather than systemic sclerosis. Option
C) Fever is a non-specific symptom and not a characteristic feature of systemic sclerosis. Option
D) Rash is also not a typical feature of systemic sclerosis in children.

Educationally, this question helps students differentiate between symptoms of different pediatric conditions, reinforcing the importance of recognizing hallmark signs for accurate diagnosis and treatment. Understanding systemic sclerosis in children is essential for early intervention and improved outcomes.

Correct Answer: D

Rationale: Reactive arthritis is a condition characterized by the classic triad of arthritis, urethritis, and conjunctivitis.
Therefore, option D, "All of the above," is the correct answer. Conjunctivitis, inflammation of the eyes' outer membrane, commonly occurs in reactive arthritis due to the body's immune response. Urethritis, inflammation of the urethra, is another common feature, often accompanied by arthritis, joint inflammation.

Option A, conjunctivitis, and option B, urethritis, are incorrect alone because reactive arthritis involves a combination of symptoms, not just one. While conjunctivitis and urethritis can occur in isolation, the hallmark of reactive arthritis is the presence of all three symptoms together.

Educationally, understanding the features of reactive arthritis is crucial for pediatric nurses as they care for children with this condition. By recognizing these symptoms, nurses can provide timely and appropriate interventions to manage the child's pain, inflammation, and discomfort. Additionally, this knowledge helps nurses educate families about the condition, its course, and the importance of following treatment plans for optimal outcomes.