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

Correct Answer: D

Rationale: In juvenile dermatomyositis (JDM), the correct answer is D) facial erythema sparing the nasolabial folds. This is because JDM commonly presents with a characteristic facial rash that involves the cheeks but spares the nasolabial folds. This distinction is important for accurate diagnosis. Option A) heliotrope rash of the eyelids is a common cutaneous manifestation of JDM characterized by a purplish discoloration of the upper eyelids, seen in about 50% of cases. Option B) photosensitivity to ultraviolet light is a common feature in JDM, leading to skin rashes upon sun exposure. Option C) Gottron papules are also classic findings in JDM, presenting as raised, scaly, violaceous papules over the knuckles and finger joints. Educationally, understanding the characteristic cutaneous manifestations of JDM is crucial for pediatric nurses to recognize and differentiate this condition from other dermatological issues. This knowledge aids in early detection, appropriate management, and improved outcomes for pediatric patients with JDM. By explaining the rationale behind each answer choice, nurses can enhance their diagnostic skills and provide comprehensive care for children with complex dermatological conditions.

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 of the aorta and its main branches. This condition typically affects young women of Asian descent. A) Henoch-Schonlein purpura primarily involves small blood vessels and is characterized by palpable purpura, joint pain, abdominal pain, and renal involvement in children. B) Polyarteritis nodosa affects medium-sized arteries and is associated with systemic symptoms such as weight loss, fever, fatigue, and muscle aches. C) Kawasaki disease mainly involves medium-sized arteries, particularly the coronary arteries, and presents with fever, rash, conjunctivitis, swollen lymph nodes, and changes in the extremities. In an educational context, understanding the specific vasculitis diseases and their target vessels is crucial for accurate diagnosis and treatment in pediatric nursing practice. Differentiating between the types of vasculitis based on the vessels affected helps healthcare providers tailor interventions and monitor for potential complications. This knowledge enhances the quality of care provided to children with these conditions.

Correct Answer: D

Rationale: In cases of retinal hemorrhage caused by abusive head trauma (AHT), it is crucial for healthcare providers, especially pediatric nurses, to be able to recognize the characteristic features to aid in early detection and intervention. The correct answer, option D, "traumatic retinoschisis," is not a characteristic of AHT-related retinal hemorrhages. Traumatic retinoschisis refers to a splitting of the retinal layers and is not typically seen in cases of AHT. Option A, "multiple," is a common characteristic of AHT-related retinal hemorrhages. These hemorrhages often present in multiple locations within the retina. Option B, "involving more than one layer of the retina," is also typical in AHT cases, as the forceful impact on the head can lead to hemorrhages that affect multiple layers of the retina. Option C, "central," is another common feature of AHT-related retinal hemorrhages. These hemorrhages often occur in the central part of the retina due to the distribution of force during abusive head trauma. For pediatric nurses, understanding these characteristic features of AHT-related retinal hemorrhages is essential for early identification, reporting, and intervention in cases of suspected child abuse. Recognizing these signs can lead to prompt intervention and protection of the child from further harm. It is crucial for nurses to be knowledgeable about the specific manifestations of abuse-related injuries to advocate for the well-being of their pediatric patients.

Correct Answer: B

Rationale: In pediatric nursing, failure to thrive is a critical concern as it indicates inadequate growth and development in children. 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 range of weight gain is considered appropriate for promoting healthy growth and development in infants experiencing failure to thrive. It allows for gradual but steady catch-up growth without overwhelming the child's system. Rapid weight gain can lead to issues like metabolic disturbances and increased risk of obesity later in life. Option A (10 gm/kg/day) is too low to support adequate catch-up growth in a child with failure to thrive. Option C (40-50 gm/kg/day) and Option D (60 gm/kg/day) represent excessive weight gain targets, which can be harmful and lead to complications such as overfeeding, increased fat deposition, and potential metabolic issues. Educationally, understanding the appropriate weight gain targets in pediatric nursing is crucial for providing optimal care to children with failure to thrive. Nurses need to monitor growth parameters closely, adjust feeding regimens as necessary, and support families in promoting healthy weight gain in their children. This knowledge ensures that interventions are evidence-based and tailored to each child's specific needs for optimal outcomes in pediatric healthcare.

Correct Answer: A

Rationale: The correct answer is A) Erythroblastosis fetalis. This condition, also known as hemolytic disease of the newborn, occurs when a mother and baby have incompatible blood types, leading to maternal antibodies attacking fetal red blood cells. The positive Coombs test indicates the presence of these antibodies in the maternal blood, confirming the diagnosis. Option B) Hereditary spherocytosis is incorrect because it is a genetic condition characterized by abnormal red blood cells, not maternal-fetal blood type incompatibility. Option C) Chronic fetal-maternal hemorrhage is not the best choice as it does not explain the specific symptoms presented by the infant. Option D) ABO incompatibility is not likely as the symptoms described are more indicative of Rh incompatibility. In an educational context, understanding the pathophysiology of hemolytic disease of the newborn is crucial for pediatric nurses to provide appropriate care and interventions for affected infants. Recognizing the signs and symptoms, conducting the necessary tests like the Coombs test, and implementing treatments such as phototherapy or exchange transfusions are essential skills for pediatric nursing practice.