A 5-day-old infant presents with severe heart failure, poor perfusion, and a gallop rhythm. What is the most likely diagnosis?

Correct Answer: D

Rationale: In this scenario, the most likely diagnosis for a 5-day-old infant presenting with severe heart failure, poor perfusion, and a gallop rhythm is option D) Hypoplastic left heart. Hypoplastic left heart syndrome is a critical congenital heart defect where the left side of the heart is underdeveloped, resulting in inadequate blood flow to the body. Infants with this condition typically present with signs of heart failure early in life due to the inability of the heart to effectively pump blood to meet the body's needs. Option A) Arteriovenous malformation is a vascular disorder, not a congenital heart defect, and would not present with the specific cardiac symptoms described. Option B) Atrioventricular septal defect is a type of congenital heart defect but typically presents with different symptoms such as a holosystolic murmur and signs of heart failure that are different from those described in the case. Option C) Coarctation of the aorta is a narrowing of the aorta, which can lead to high blood pressure and differences in blood pressure between the upper and lower extremities. While it can present with poor perfusion, it does not typically present with the severe heart failure and gallop rhythm described in the case. Educationally, understanding the different presentations of congenital heart defects in infants is crucial for pediatric nurses. Recognizing the specific signs and symptoms of each condition allows for timely intervention and appropriate management to improve patient outcomes. In this case, identifying the critical nature of hypoplastic left heart syndrome and initiating prompt treatment is essential for the infant's well-being.

Correct Answer: D

Rationale: Cromolyn is a medication used in the management of asthma, allergic rhinitis, and other allergic conditions. The correct answer, option D, states that all the statements are true. Let's break down each option to understand why the correct answer is right and why the others are incorrect: A) It prevents antibody-mediated mast cell degranulation: This statement is true. Cromolyn works by stabilizing mast cells, preventing the release of inflammatory mediators like histamine in response to allergens. This action helps in reducing allergic symptoms. B) It prevents non-antibody-mediated mast cell degranulation: This statement is also true. Cromolyn not only inhibits the release of mediators triggered by antibodies but also those induced by non-antibody mechanisms, providing a broad anti-inflammatory effect. C) It has no bronchodilator properties: This statement is false. Cromolyn is not a bronchodilator. Instead, it helps in preventing asthma attacks by reducing the release of inflammatory substances, but it does not directly dilate the airways like bronchodilators such as albuterol. In an educational context, understanding the mechanisms of action of medications like cromolyn is crucial for pediatric nurses caring for children with asthma and allergies. By grasping how cromolyn works to prevent mast cell degranulation, nurses can better educate patients and families on the proper use of the medication and its role in managing these conditions effectively. This knowledge also aids in assessing treatment effectiveness and potential side effects, contributing to improved patient outcomes.

Correct Answer: C

Rationale: In the context of pediatric nursing, understanding the causes of angioedema without urticaria is crucial for providing safe and effective care to pediatric patients. In this scenario, the correct answer is C) Foods. Angioedema without urticaria can be caused by various factors, including allergic reactions to certain foods such as nuts, shellfish, or fruits. ACE inhibitors (Option A) are a common cause of angioedema with urticaria, making this option incorrect in the context of the question. Hereditary angioedema (Option B) is a genetic condition that can cause recurrent episodes of angioedema with or without urticaria, so it is not the correct answer in this case. Insect stings (Option D) can also trigger angioedema with urticaria, but in the absence of urticaria, this is not a common cause of angioedema. Educationally, understanding the different etiologies of angioedema is essential for pediatric nurses to accurately assess, diagnose, and manage pediatric patients presenting with these symptoms. Recognizing the specific triggers for angioedema without urticaria can lead to appropriate interventions, such as avoiding specific foods or allergens, administering antihistamines, or providing emergency care in severe cases. This knowledge empowers pediatric nurses to deliver high-quality care and ensure positive patient outcomes in cases of angioedema without urticaria.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding drug-induced anaphylaxis and its common causes is crucial for providing safe and effective care to pediatric patients. The correct answer, B) Aspirin, is not a common cause of drug-induced anaphylaxis in comparison to the other options provided. Aspirin is more commonly associated with non-allergic reactions such as gastrointestinal issues or asthma exacerbation in patients with underlying respiratory conditions like asthma. Penicillin (Option A), NSAIDs (Option C), and radiocontrast media (Option D) are known to be more frequent culprits in drug-induced anaphylaxis in pediatric patients. Penicillin is one of the most common causes of drug allergies in general, including anaphylaxis. NSAIDs, especially in patients with asthma or chronic urticaria, can trigger severe allergic reactions. Radiocontrast media can also induce anaphylaxis, particularly in patients with a history of reactions to contrast agents. In an educational context, this question serves to assess the test-taker's knowledge of common triggers of drug-induced anaphylaxis in pediatric patients. Understanding these common causes is essential for nurses to promptly recognize and manage allergic reactions in pediatric patients, ensuring their safety and well-being.

Correct Answer: B

Rationale: The correct answer is B) Two major manifestations and one minor manifestation. In the case of Ahmed, he presents with migratory polyarthritis (a major manifestation), newly heard apical pansystolic murmur (a major manifestation), and positive acute phase reactants (a minor manifestation). This combination fulfills the Jones criteria for the diagnosis of rheumatic fever. Option A is incorrect as it suggests two major and two minor manifestations, which does not align with Ahmed's presentation. Option C is incorrect as it suggests one major and two minor manifestations, which is not consistent with the criteria for diagnosing rheumatic fever. Option D is incorrect as it implies only two major manifestations without considering the minor manifestations required for a definitive diagnosis. In an educational context, understanding the criteria for diagnosing rheumatic fever is crucial for pediatric nurses to accurately assess and manage patients. By recognizing the importance of major and minor manifestations, nurses can provide timely and appropriate care for children like Ahmed who are at risk for developing complications associated with rheumatic fever.