All the following are common cutaneous manifestations of juvenile dermatomyositis (JDM) EXCEPT

Correct Answer: D

Rationale: Juvenile dermatomyositis (JDM) is a rare autoimmune disease that primarily affects the skin and muscles in children. The correct answer to this question is D) facial erythema sparing the nasolabial folds is not a common cutaneous manifestation of JDM. Facial erythema sparing the nasolabial folds is typically seen in systemic lupus erythematosus (SLE) rather than JDM. This is an important differentiating factor between the two conditions. A) heliotrope rash of the eyelids, B) photosensitivity to ultraviolet light, and C) Gottron papules are all common cutaneous manifestations of JDM. The heliotrope rash is a classic finding in JDM, appearing as a purplish discoloration of the eyelids. Photosensitivity and Gottron papules (raised, scaly patches over the knuckles and finger joints) are also frequently observed in JDM cases. Understanding the specific cutaneous manifestations of pediatric diseases like JDM is crucial for nurses caring for pediatric patients. Recognizing these signs early can lead to prompt diagnosis and appropriate management, ultimately improving patient outcomes. It is essential for pediatric nurses to be knowledgeable about common pediatric conditions and their clinical presentations to provide optimal care to their young patients.

Correct Answer: D

Rationale: The correct answer is D) Takayasu arteritis, as it predominantly affects large blood vessels. Takayasu arteritis is a rare autoimmune disease that causes inflammation in the walls of the aorta and its main branches. This results in narrowing or blockage of these arteries, leading to reduced blood flow to various organs. Option A) Henoch-Schonlein purpura primarily involves small blood vessels and is characterized by a rash, joint pain, gastrointestinal symptoms, and kidney inflammation. Option B) Polyarteritis nodosa affects medium-sized arteries, leading to organ damage due to poor blood supply. It typically does not involve large blood vessels as in the case of Takayasu arteritis. Option C) Kawasaki disease mainly affects medium-sized arteries, particularly the coronary arteries in children. It is characterized by fever, rash, swollen lymph nodes, red eyes, lips, and tongue, and can lead to coronary artery aneurysms if not treated promptly. Educationally, understanding the differences in the types of vasculitis based on the size of blood vessels affected is crucial for pediatric nurses. Recognizing the specific characteristics and target organs of each disease aids in accurate diagnosis, appropriate treatment, and prevention of complications. Nurses play a key role in early identification, monitoring, and management of vasculitis in children to promote optimal outcomes and quality of life.

Correct Answer: D

Rationale: In cases of retinal hemorrhage caused by abusive head trauma (AHT), one of the key distinguishing features is the presence of traumatic retinoschisis. This condition is not typically associated with AHT-related retinal hemorrhages, making option D the correct answer. Multiple retinal hemorrhages are a common finding in AHT cases, which aligns with option A. These hemorrhages often involve multiple layers of the retina (option B) and are frequently located centrally (option C). However, traumatic retinoschisis, which involves a splitting of the retinal layers, is not a typical feature of AHT-related retinal hemorrhages. Educationally, understanding the specific characteristics of retinal hemorrhages in cases of AHT is crucial for pediatric nurses as they play a vital role in identifying and reporting suspected cases of child abuse. Recognizing these distinctive features can aid in early detection and intervention, ultimately safeguarding the well-being of vulnerable pediatric patients.

Correct Answer: B

Rationale: In pediatric nursing, failure to thrive is a critical issue that requires close monitoring and intervention. The correct answer, option B (20-30 gm/kg/day), is the minimal accepted catch-up weight gain for a 10-month-old child with failure to thrive. This rate of weight gain is considered appropriate for achieving catch-up growth without overloading the child's system. Option A (10 gm/kg/day) is too low for a child with failure to thrive to adequately catch up in weight gain. This rate may not provide sufficient nutritional support for the child's growth needs. Option C (40-50 gm/kg/day) and option D (60 gm/kg/day) are too high and could potentially lead to overfeeding, which may overwhelm the child's digestive system and cause other complications. Educationally, understanding the appropriate rate of weight gain in children with failure to thrive is crucial for pediatric nurses. It helps them tailor feeding plans to meet the specific needs of each child, promoting optimal growth and development. Monitoring weight gain closely and adjusting feeding strategies accordingly is essential in managing failure to thrive in pediatric patients.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Erythroblastosis fetalis. Erythroblastosis fetalis occurs when there is an incompatibility between the blood types of the mother and the fetus, leading to the mother's antibodies attacking the baby's red blood cells. This condition can cause anemia, jaundice, and hepatosplenomegaly in the newborn. Option B) Hereditary spherocytosis is a genetic disorder that leads to hemolytic anemia due to abnormal red blood cell shape. However, the clinical presentation in the question, including the positive Coombs test and Apgar scores, is more indicative of an immune response causing hemolysis rather than a genetic defect. Option C) Chronic fetal-maternal hemorrhage is unlikely in this case as the infant's symptoms are more suggestive of a hemolytic process rather than hemorrhage. Option D) ABO incompatibility is another condition where the mother's antibodies attack the baby's red blood cells, but it typically presents with less severe symptoms compared to erythroblastosis fetalis. Educationally, understanding these differentials is crucial for pediatric nurses to provide appropriate care for neonates experiencing hemolytic processes. Recognizing the signs and symptoms of erythroblastosis fetalis can lead to prompt interventions such as exchange transfusions to prevent severe complications in affected infants.