A classic example of type III (immune complex) reactions is

Correct Answer: A

Rationale: In pediatric nursing practice, understanding different types of immune reactions is crucial for providing safe and effective care to children. In this question, the correct answer is A) serum sickness, which is a classic example of a type III (immune complex) reaction. Serum sickness occurs when there is an excessive immune response to antigens in the blood, leading to the formation of immune complexes that deposit in tissues and cause inflammation. This reaction is characteristic of type III hypersensitivity reactions, where immune complexes are deposited in various tissues, leading to inflammatory responses. Option B) TB skin test reactions are examples of type IV (delayed-type) hypersensitivity reactions, not type III reactions. These reactions involve T cells and do not typically involve immune complexes. Option C) contact dermatitis (neomycin) is an example of a type IV hypersensitivity reaction, specifically a contact hypersensitivity reaction mediated by T cells. Option D) graft versus-host disease is a complication of allogeneic stem cell transplantation and is caused by donor T cells attacking the recipient's tissues. This is not an example of a type III hypersensitivity reaction. Understanding the differences between these types of immune reactions is essential for pediatric nurses to accurately assess and manage various immune-related conditions in children. Recognizing the specific characteristics of each type of hypersensitivity reaction helps nurses provide appropriate care and interventions to pediatric patients experiencing these immune responses.

Correct Answer: D

Rationale: In pediatric nursing, it is crucial to understand the significance of signs and symptoms that may indicate underlying health conditions. In this scenario, nasal polyps in children under 10 years old should prompt evaluation for primary ciliary dyskinesia (PCD), making option D the correct answer. Primary ciliary dyskinesia is a genetic disorder affecting cilia's structure and function, leading to recurrent respiratory infections, chronic otitis media, and nasal polyps. These symptoms result from impaired mucociliary clearance due to dysfunctional cilia. The other options (A) celiac disease, (B) ulcerative colitis, and (C) unilateral choanal atresia are less likely causes of nasal polyps in this age group. Celiac disease and ulcerative colitis primarily affect the gastrointestinal tract and do not typically present with nasal polyps. Unilateral choanal atresia is a congenital nasal anomaly characterized by blockage of one nasal passage, but it does not commonly cause bilateral nasal polyps. Educationally, understanding the association between nasal polyps and PCD reinforces the importance of considering rare genetic disorders in the differential diagnosis of pediatric patients. It also highlights the necessity of a comprehensive assessment to accurately diagnose and manage conditions in pediatric nursing practice.

Correct Answer: D

Rationale: Atopic dermatitis is a common inflammatory skin condition in children. Staphylococcus aureus colonization is frequently seen in patients with atopic dermatitis, with more than 90% of affected individuals having colonization of lesional skin. The correct answer, option D) 50%, refers to the colonization rate of uninvolved skin in patients with atopic dermatitis. Option A) 5% is incorrect because the colonization rate is much higher in patients with atopic dermatitis. Option B) 15% is also incorrect as it underestimates the prevalence of colonization on uninvolved skin in these patients. Option C) 25% is closer but still lower than the actual colonization rate. Understanding the high colonization rates of Staphylococcus aureus in patients with atopic dermatitis is crucial for nurses caring for pediatric patients. It is important to educate patients and families on proper skin care, hygiene practices, and the management of atopic dermatitis to reduce the risk of infection and exacerbations of the condition. Nurses play a key role in providing education, support, and guidance to promote optimal skin health in pediatric patients with atopic dermatitis.

Correct Answer: B

Rationale: In pediatric nursing practice, understanding the risk factors for drug reactions to penicillins and cephalosporins is crucial for safe medication administration. The correct answer, option B, "increasing age (>20 years)," is right because pediatrics refers to the care of infants, children, and adolescents, typically up to 18 years of age. Therefore, individuals above 20 years are not considered pediatric patients. Option A, "previous drug exposure," is a common risk factor for drug reactions as sensitization can develop after initial exposure. This is especially relevant in pediatrics where children may have had previous medication exposures. Option C, "higher dose," is a significant risk factor for drug reactions as dosing errors or inappropriate dosages can lead to adverse reactions. In pediatrics, dosing calculations must be precise due to the child's size and weight. Option D, "intermittent repeated exposure," is also a risk factor as repeated exposures can increase the likelihood of developing sensitivities or reactions to the medication, especially in pediatrics where repeated courses of antibiotics are common. Educationally, understanding these risk factors is vital for pediatric nurses to ensure safe medication practices. By recognizing factors that contribute to drug reactions, nurses can implement preventive measures, such as thorough patient assessments, accurate dosing calculations, and monitoring for adverse effects. This knowledge enhances patient safety and quality of care in pediatric nursing practice.

Correct Answer: D

Rationale: The most likely diagnosis for the 7-year-old boy exhibiting separation anxiety, temper issues, and withdrawal from activities after his parents' divorce is D) Separation anxiety disorder. The correct answer, Separation anxiety disorder, is characterized by excessive anxiety concerning separation from home or from those to whom the individual is attached. In this case, the boy's symptoms align with the hallmark features of this disorder following a significant life event like his parents' divorce. Option A) Attention deficit hyperactivity disorder (ADHD) is characterized by symptoms such as inattention, hyperactivity, and impulsivity, which are different from the boy's presentation. Option B) Conduct disorder involves a pattern of violating the basic rights of others or major age-appropriate societal norms, which does not align with the symptoms described for the boy. Option C) Major depressive disorder typically includes symptoms like persistent sadness, loss of interest, changes in appetite or sleep, which are not the primary symptoms exhibited by the boy in this scenario. In an educational context, it is crucial for healthcare providers working with children to be able to differentiate between various childhood behavioral and emotional disorders based on their unique presentations. Understanding the diagnostic criteria for each disorder is essential for effective assessment, intervention, and support for children experiencing mental health challenges. Identifying and addressing separation anxiety disorder in children can help in providing appropriate interventions to support their emotional well-being during challenging life transitions.