A significant risk factor in the development of allergic rhinitis in children is

Correct Answer: A

Rationale: In pediatric nursing, understanding risk factors for conditions like allergic rhinitis is crucial for providing effective care. The correct answer is A) positive family history. This is because allergic rhinitis has a strong genetic component, making children with a family history of allergies more likely to develop the condition. Option B) serum IgA higher than 100 iu/ml is incorrect because elevated IgA levels are not a known risk factor for allergic rhinitis in children. Option C) alcoholic mother is incorrect as alcohol consumption by the mother is not directly linked to the development of allergic rhinitis in children. Option D) diabetic mother is also incorrect as maternal diabetes is not a recognized risk factor for allergic rhinitis specifically. Educationally, understanding the relationship between genetics and allergic conditions can help healthcare providers assess and manage pediatric patients more effectively. By recognizing the significance of family history in allergic rhinitis, nurses can provide tailored education and interventions to prevent and manage symptoms in at-risk children.

Correct Answer: C

Rationale: In pediatric nursing, understanding the prevalence and progression of asthma in children is crucial for effective care and management. The correct answer is C) one-third. This means that approximately one-third of preschool-age children with recurrent coughing and wheezing will continue to have persistent asthma into later childhood. This is the right answer because research and clinical data support the fact that a significant proportion of children with early respiratory symptoms go on to develop persistent asthma. Understanding this statistic helps healthcare providers identify at-risk children early, provide appropriate interventions, and monitor their progress effectively. Option A) one-fifth is incorrect because it underestimates the prevalence of persistent asthma in children with recurrent symptoms. Option B) one-fourth is also incorrect as it does not accurately reflect the data showing a higher percentage of children progressing to persistent asthma. Option D) one-half is incorrect as it overestimates the proportion of children with persistent asthma, which could lead to misinterpretation and inappropriate management. In an educational context, knowing this statistic equips nursing students and healthcare professionals with evidence-based knowledge to deliver informed care to pediatric patients with asthma. It underscores the importance of early recognition, thorough assessment, and tailored interventions to improve outcomes for children with respiratory conditions.

Correct Answer: D

Rationale: In this scenario, the most appropriate discharge medication is the combination of inhaled B-agonist plus oral corticosteroid (Option D). This choice is correct because it addresses both the bronchodilation provided by the inhaled B-agonist to relieve acute symptoms and the anti-inflammatory effect of the oral corticosteroid to prevent relapse and exacerbation of the condition. Option A (inhaled B-agonist only) is not sufficient for long-term management, as it does not address the underlying inflammation in conditions like asthma. Option B (oral corticosteroid only) may be used in severe cases but lacks the immediate bronchodilator effect needed for symptomatic relief in the emergency department. Option C (inhaled corticosteroid only) is more focused on long-term control and prevention of symptoms rather than addressing acute exacerbations. The combination of inhaled B-agonist and oral corticosteroid (Option D) is the most comprehensive approach to manage both acute symptoms and prevent future exacerbations, making it the most suitable choice in this scenario. In an educational context, understanding the rationale behind medication choices in pediatric nursing is crucial for providing safe and effective care to pediatric patients. By knowing which medications are appropriate for different situations, nurses can optimize patient outcomes and ensure continuity of care from the emergency department to home management.

Correct Answer: A

Rationale: In pediatric nursing, understanding common skin conditions like atopic dermatitis is crucial for providing effective care to children. In the case of older children with chronic atopic dermatitis, lichenification and localized tendencies are key clinical manifestations to consider. The correct answer is A) flexural folds of the extremities. This is because chronic atopic dermatitis often leads to lichenification, which is the thickening and hardening of the skin due to chronic irritation and scratching. In older children, the flexural folds of the extremities, such as the elbows and knees, are common sites for lichenification in atopic dermatitis. Option B) forehead is incorrect because atopic dermatitis typically affects flexural areas rather than the forehead in older children. Option C) scalp is also incorrect as atopic dermatitis tends to spare the scalp in older children. Option D) diaper area is incorrect as this area is more commonly affected in infants with atopic dermatitis due to irritants from urine and feces. Educationally, this question highlights the importance of recognizing the specific manifestations of atopic dermatitis in older children, such as lichenification in flexural folds. By understanding these clinical features, nurses can provide targeted care and education to manage the condition effectively, improving the quality of life for pediatric patients with chronic atopic dermatitis.

Correct Answer: D

Rationale: The correct answer is D) the majority of patients react to more than 3 foods. This statement is true in the context of pediatric patients with atopic dermatitis and food allergies. It is important to understand that children with atopic dermatitis are at a higher risk for developing food allergies. Research indicates that these patients often have multiple food allergies, with reactions to more than 3 foods being common. Option A is incorrect because negative skin and blood test results do not definitively rule out food allergies, especially in patients with atopic dermatitis. False negatives can occur, leading to a low predictive value for excluding suspected allergens. Option B is incorrect as positive results from skin or blood tests need to be confirmed with controlled food challenges to accurately diagnose food allergies. Clinical symptoms should always be correlated with test results for an accurate diagnosis. Option C is incorrect because while elimination diets may be necessary for some patients with food allergies, they are not always extensively required and should be managed under the guidance of a healthcare provider. In an educational context, understanding the nuances of diagnosing food allergies in pediatric patients with atopic dermatitis is crucial for providing effective care. Emphasizing the need for comprehensive evaluation, including clinical symptoms, test results, and controlled challenges, can help healthcare providers make accurate diagnoses and create appropriate management plans for these patients.