After institution of treatment of anaphylaxis, the patient should be monitored in the emergency room for at least

Correct Answer: B

Rationale: In the management of anaphylaxis, the patient should be monitored in the emergency room for at least 4 hours after the institution of treatment. This timeframe allows for the observation of potential delayed or biphasic reactions which can occur even after the initial treatment response. Option A, monitoring for 1 hour, is not sufficient as anaphylaxis reactions can have a delayed onset and may not manifest within the first hour. Option C, monitoring for 6 hours, is longer than the recommended timeframe for monitoring post-anaphylaxis treatment. Option D, monitoring for 12 hours, is excessive and not supported by current guidelines unless there are specific risk factors or concerns for prolonged monitoring. Educationally, understanding the appropriate duration of monitoring post-anaphylaxis treatment is crucial for pediatric clinical nurse specialists to ensure patient safety and prompt management of any potential complications. It highlights the importance of ongoing assessment and vigilance in the care of patients who have experienced anaphylaxis.

Correct Answer: C

Rationale: In the context of the Pediatric Clinical Nurse Specialist exam, understanding Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) is crucial for providing safe and effective care to pediatric patients. The correct answer is C) allopurinol. Allopurinol is a xanthine oxidase inhibitor used in the treatment of gout and hyperuricemia. It is known to cause DRESS syndrome in some patients. DRESS syndrome is a severe drug reaction characterized by rash, fever, eosinophilia, and systemic organ involvement. Anticonvulsants, sulfonamides, and minocycline are all known culprits in causing DRESS syndrome. Anticonvulsants like carbamazepine and phenytoin, sulfonamides like trimethoprim-sulfamethoxazole, and minocycline, a tetracycline antibiotic, have all been associated with DRESS syndrome in pediatric patients. Educationally, knowing the drugs that can cause DRESS syndrome is essential for nurses to recognize and manage this potentially life-threatening condition promptly. By understanding the specific medications implicated in DRESS syndrome, nurses can advocate for appropriate medication management and provide comprehensive care to pediatric patients experiencing adverse drug reactions.

Correct Answer: A

Rationale: The correct answer is A) 15 to 20 minutes. In vivo skin testing for allergen-specific IgE involves introducing a small amount of allergen under the skin, causing a wheal (raised bump) and flare (redness) reaction if the person is allergic. This reaction is typically measured within 15 to 20 minutes after the allergen is introduced. Option B) 30 to 60 minutes is incorrect because the wheal and flare reaction is usually assessed before this time frame. Option C) 12 to 24 hours is incorrect as this time frame is more indicative of delayed hypersensitivity reactions, not immediate IgE-mediated responses. Option D) 24 to 48 hours is also incorrect as it is too long of a time frame for assessing the immediate wheal and flare reaction associated with IgE-mediated allergies. Understanding the timing of skin testing reactions is crucial for pediatric clinical nurse specialists when assessing and diagnosing allergies in children. Knowing when to expect a reaction allows for timely interpretation and appropriate management. This knowledge aids in providing accurate information to healthcare providers and families, leading to better patient outcomes.

Correct Answer: B

Rationale: The correct answer is B) three or more episodes of wheezing that lasted more than 1 day. Daily long-term control therapy is recommended for infants and young children in this age group who have had three or more episodes of wheezing in the previous year. This recommendation is based on evidence that children who experience frequent wheezing episodes are at higher risk for developing asthma. Option A) two or more episodes is not the correct answer because the threshold for initiating daily long-term control therapy is set at three or more episodes. Option C) four or more episodes and Option D) five or more episodes are also incorrect as they exceed the threshold recommended for initiating daily long-term control therapy in this age group. From an educational perspective, understanding the criteria for initiating daily long-term control therapy in infants and young children is crucial for pediatric clinical nurse specialists. It allows for early intervention and management of asthma symptoms, ultimately improving outcomes for these young patients. Nurses need to be knowledgeable about evidence-based guidelines to provide optimal care to pediatric patients with respiratory conditions.

Correct Answer: C

Rationale: In the management of nasal congestion associated with rhinitis, pseudoephedrine (Option C) is the preferred choice for relief. Pseudoephedrine is a decongestant that works by constricting blood vessels in the nasal passages, thereby reducing swelling and congestion. It is effective in providing symptomatic relief of nasal congestion. Option A, diphenhydramine, is an antihistamine that may help with allergies and itching but is not as effective in relieving nasal congestion compared to decongestants like pseudoephedrine. Option B, hydroxyzine, is also an antihistamine that is more commonly used for itching and anxiety rather than nasal congestion. Option D, cetirizine, is a second-generation antihistamine that is effective for treating allergies and associated symptoms like sneezing and itching, but it is not as effective in relieving nasal congestion as pseudoephedrine. Educationally, understanding the appropriate pharmacological management of symptoms related to rhinitis is crucial for healthcare providers, especially pediatric clinical nurse specialists, as they play a vital role in managing pediatric patients with respiratory conditions. It is essential to differentiate between various classes of medications and their specific uses to provide safe and effective care to pediatric patients with rhinitis.