A 12-year-old child presents with watery rhinorrhea, paroxysmal sneezing, and nasal obstruction... Which is the recommended treatment?

Correct Answer: C

Rationale: The recommended treatment for a 12-year-old child presenting with watery rhinorrhea, paroxysmal sneezing, and nasal obstruction is to begin seasonal use of topical corticosteroids (Option C). This is the correct answer because these symptoms suggest allergic rhinitis, which is effectively managed with intranasal corticosteroids. Option A, instituting strict measures to avoid outdoor allergen exposure, is not the primary treatment for allergic rhinitis and may not provide sufficient relief for the child. Option B, starting sympathomimetic drugs, is not the first-line treatment for allergic rhinitis in children. Option D, prescribing amoxicillin for 10 days, is incorrect because antibiotics are not indicated for allergic rhinitis unless there is a concomitant bacterial infection, which is not the case in this scenario. Educationally, it's crucial to understand the appropriate management of allergic rhinitis in pediatric patients to provide optimal care. Topical corticosteroids are safe and effective in reducing nasal inflammation and symptoms, making them a cornerstone of treatment for allergic rhinitis. Recognizing the symptoms and selecting the right treatment approach can significantly improve the child's quality of life and prevent complications associated with untreated allergic rhinitis.

Correct Answer: B

Rationale: Insect sting anaphylaxis is a critical topic in pediatric nursing as it can lead to life-threatening situations. The correct answer, B) Mosquitoes, is not a common cause of insect sting anaphylaxis. Mosquito bites typically result in local reactions like redness and swelling, rather than systemic allergic reactions. It is crucial for pediatric nurses to understand this to differentiate between mild local reactions and severe anaphylactic responses. A) Honeybees are a common cause of insect sting anaphylaxis due to the venom they inject when they sting. C) Wasps also inject potent venom that can trigger severe allergic reactions in some individuals. D) Fire ants are known to cause anaphylactic reactions in some people due to the venom they release when they sting. Educationally, this question helps reinforce the importance of recognizing common allergens and potential triggers for anaphylaxis in pediatric patients. Nurses must be able to quickly identify the causative agent and initiate appropriate interventions in case of an allergic reaction. Understanding the nuances of various insect stings and their potential outcomes is vital for providing safe and effective care to pediatric patients.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Early sepsis, as it can cause distributive shock. Distributive shock, also known as vasogenic shock, is characterized by widespread vasodilation and decreased systemic vascular resistance, leading to inadequate tissue perfusion and oxygen delivery. Early sepsis, a systemic inflammatory response to infection, can trigger a cascade of events that result in the release of vasodilatory mediators, causing distributive shock. Option B) Tension pneumothorax is incorrect as it causes obstructive shock due to impaired venous return caused by increased intrathoracic pressure. This leads to decreased cardiac output and inadequate tissue perfusion. Option C) Cardiac tamponade causes obstructive shock by compressing the heart chambers, impairing filling and reducing cardiac output, resulting in inadequate tissue perfusion. Option D) Aortic stenosis causes cardiogenic shock due to the heart's inability to pump effectively against increased afterload, leading to decreased cardiac output and inadequate tissue perfusion. Educational Context: Understanding the different types of shock is crucial in pediatric nursing as it helps in timely recognition and appropriate management of critically ill pediatric patients. Distributive shock, like in early sepsis, requires interventions such as fluid resuscitation and vasopressor therapy to restore adequate tissue perfusion. By differentiating between distributive, obstructive, and cardiogenic shock and recognizing their specific etiologies, nurses can provide targeted care to stabilize pediatric patients in shock.

Correct Answer: B

Rationale: In a newborn with cyanotic congenital heart disease, pulmonary oligemia, and left ventricular hypertrophy, the correct diagnosis is likely tricuspid atresia. Tricuspid atresia is a congenital heart defect where the tricuspid valve is either missing or abnormally developed, leading to decreased blood flow to the lungs (pulmonary oligemia) and subsequent left ventricular hypertrophy due to increased workload. Option A, truncus arteriosus, is characterized by a single arterial trunk arising from the heart, which would typically present with increased pulmonary blood flow rather than oligemia. Option C, tetralogy of Fallot, usually presents with pulmonary stenosis leading to right ventricular hypertrophy, not left ventricular hypertrophy. Option D, transposition of the great arteries with a large ventricular septal defect (VSD), would present with a different set of hemodynamic findings, such as increased pulmonary blood flow and cyanosis without left ventricular hypertrophy. Understanding the pathophysiology of each congenital heart defect is crucial for pediatric nurses to provide optimal care. Recognizing the specific signs and symptoms associated with each condition is vital for timely interventions and improving patient outcomes. This question challenges students to apply their knowledge of cyanotic heart defects and hemodynamic consequences in newborns, reinforcing the importance of accurate clinical assessment and critical thinking skills in pediatric nursing practice.

Correct Answer: D

Rationale: In the treatment of infective endocarditis, option D, which is the administration of an immunosuppressive dose of corticosteroids tapered over 4-6 weeks, is contraindicated. This is because corticosteroids can suppress the immune system, which is essential in fighting off the infection in infective endocarditis. By using immunosuppressive therapy, the body's ability to combat the infection is compromised, leading to potential worsening of the condition and increased risk of complications. Option A, intravenous antibiotics empiric therapy till culture results, is a common initial approach to treating infective endocarditis to provide immediate coverage while awaiting culture results. Option B, long-term antibiotics based on culture results, is also a standard treatment for infective endocarditis to target the specific causative microorganism for an extended duration to eradicate the infection. Option C, surgical removal of vegetation, may be considered in certain cases of infective endocarditis where there are large or complicated vegetations that are causing severe issues like valve obstruction or systemic embolization. In an educational context, understanding the contraindications in the treatment of infective endocarditis is crucial for nursing students and healthcare professionals to provide safe and effective care for pediatric patients. Recognizing the inappropriate use of immunosuppressive therapy in this condition is essential to prevent potential harm and complications. It also highlights the importance of evidence-based practice and following established guidelines in pediatric nursing to optimize patient outcomes.