A 14-year-old boy develops a youth violence that has been started 6 months ago. The parents are asking about the factors that may increase the risks for serious violence. Of the following, the MOST important risk factor for development of serious youth violence in this boy is

Correct Answer: C

Rationale: In this scenario, the most important risk factor for the development of serious youth violence in the 14-year-old boy is having antisocial delinquent friends (Option C). This is because peer influence plays a significant role in shaping behaviors during adolescence. The boy is at higher risk of engaging in serious violence if he is surrounded by friends who exhibit antisocial behaviors, as he may be more likely to mimic their actions or be pressured into risky behaviors. Substance abuse (Option B) is a significant risk factor for various negative outcomes in adolescents, including violence, but in this case, the influence of delinquent friends is considered the most important factor. Male gender (Option A) is a demographic factor that may contribute to a higher overall risk of violence in adolescence, but it is not as influential as the immediate social environment of having delinquent friends. Low IQ (Option D) may impact decision-making and problem-solving abilities, but in the context of serious youth violence, the influence of peer relationships on behavior is considered a more critical factor. Educationally, this question highlights the importance of understanding the social determinants of behavior in adolescents. It emphasizes the significant impact that peer relationships can have on shaping behaviors and the need for interventions that address both individual risk factors and social influences in preventing youth violence.

Correct Answer: A

Rationale: In pediatric nursing, it is crucial to understand the appropriate treatment options for conditions like juvenile idiopathic arthritis (JIA). The first-line treatment for JIA is nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. NSAIDs are preferred initially due to their effectiveness in managing pain and inflammation in JIA without the systemic side effects associated with other medications. They are also well-tolerated by children in general. Biologics, corticosteroids, and disease-modifying antirheumatic drugs (DMARDs) are not typically used as first-line treatments for JIA. Biologics and DMARDs are usually reserved for cases where NSAIDs are ineffective or if there is a need for more aggressive therapy. Corticosteroids may be used for short-term management of severe symptoms but are not preferred due to their potential long-term side effects in children. Educationally, understanding the rationale behind selecting NSAIDs as the first-line treatment for JIA not only reinforces knowledge of appropriate pharmacological interventions but also highlights the importance of considering factors such as efficacy, safety, and patient age when making treatment decisions in pediatric patients with chronic conditions.

Correct Answer: D

Rationale: In managing systemic lupus erythematosus (SLE), a multisystem autoimmune disease, the first-line treatment often includes hydroxychloroquine (Option D). Hydroxychloroquine is considered a cornerstone therapy for SLE as it helps in controlling disease activity, reducing flares, and protecting against organ damage. It is beneficial in managing skin and joint symptoms commonly seen in SLE patients. Additionally, hydroxychloroquine has been shown to improve overall outcomes and reduce mortality in SLE. Corticosteroids (Option A) are commonly used in the treatment of SLE to quickly suppress inflammation during disease flares. However, they are typically used in conjunction with other medications for long-term management due to their potential for significant side effects when used alone or for extended periods. Mycophenolate mofetil (Option B) and azathioprine (Option C) are immunosuppressive medications that are often used in SLE when patients do not respond adequately to first-line therapies or in cases of severe organ involvement. They are considered second-line treatments due to their stronger immunosuppressive effects and potential for more serious side effects compared to hydroxychloroquine. In an educational context, understanding the rationale behind treatment choices in SLE is crucial for nurses working with pediatric patients with this condition. By knowing the appropriate first-line therapy like hydroxychloroquine, nurses can contribute to effective disease management, symptom control, and improved quality of life for pediatric patients with SLE. It is important for nurses to stay updated on current treatment guidelines and be able to explain the rationale behind different treatment options to patients and their families.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding mixed connective tissue disease (MCTD) is crucial for providing comprehensive care to young patients. The correct answer, option D (All of the above), is the most appropriate choice because MCTD is characterized by a combination of symptoms from various connective tissue disorders, including Raynaud's phenomenon, joint pain, and lung involvement. Raynaud's phenomenon, marked by color changes in the extremities in response to cold or stress, is a common feature of MCTD due to vascular involvement. Joint pain is another key symptom, resembling that seen in conditions like rheumatoid arthritis and lupus, as MCTD affects the joints and causes inflammation. Lung involvement, such as interstitial lung disease, is also prevalent in MCTD, leading to respiratory symptoms and potential complications. Options A, B, and C can be deemed incorrect in isolation because MCTD is a complex condition that often presents with a combination of symptoms from different connective tissue disorders, rather than a single distinct feature. By selecting option D, students can grasp the comprehensive nature of MCTD and its multisystem involvement, preparing them to recognize and manage this condition effectively in pediatric patients. This question underscores the importance of recognizing the diverse clinical manifestations of MCTD, enhancing students' diagnostic skills and clinical reasoning abilities in pediatric nursing practice.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the consequences of deforestation is crucial as it directly impacts children's health and well-being. The correct answer is D) Loss of biodiversity. Deforestation leads to the destruction of natural habitats, causing a significant loss of plant and animal species. This loss of biodiversity can have detrimental effects on ecosystems, disrupting food chains and leading to imbalances that can ultimately harm human health. Option A) Improved wildlife habitats is incorrect because deforestation actually destroys wildlife habitats, leading to a decline in biodiversity. Option B) Increased oxygen levels is incorrect because trees, which produce oxygen, are removed during deforestation, leading to a decrease in oxygen levels. Option C) More arable land is incorrect because while deforestation does clear land for agriculture, the long-term consequences such as soil erosion and loss of biodiversity outweigh the short-term benefits. Educationally, this question serves to highlight the importance of environmental conservation in pediatric nursing practice. Nurses working with children need to be aware of how environmental factors, such as deforestation, can impact the health of their patients. By understanding the consequences of deforestation, nurses can advocate for policies and practices that promote environmental sustainability and ultimately contribute to better health outcomes for children.