All the following are features of childhood SLE EXCEPT

Correct Answer: C

Rationale: The correct answer is C) it usually presents before 5 years of age. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect people of all ages, including children. However, childhood-onset SLE typically presents in older children and adolescents, with the peak onset around puberty. SLE in young children, especially before the age of 5, is extremely rare. Option A) it has a more severe course is incorrect because childhood SLE generally has a milder course compared to adult-onset SLE. Children tend to have fewer organ complications and a better prognosis. Option B) there is more widespread organ involvement is incorrect as childhood SLE often involves fewer organs compared to adult SLE. Organ involvement in children is typically milder and less extensive. Option D) fever, fatigue, hematologic abnormalities, and arthritis are common clinical manifestations is incorrect because these are indeed common clinical manifestations of childhood SLE. Children with SLE commonly present with symptoms like fever, fatigue, blood disorders, and arthritis. Educationally, understanding the differences in the presentation and course of SLE in children compared to adults is crucial for healthcare providers working with pediatric populations. Recognizing the unique features of childhood SLE can aid in early diagnosis, appropriate management, and improved outcomes for pediatric patients with this condition.

Correct Answer: A

Rationale: In Kawasaki disease (KD), predictors of poor outcomes are essential to recognize for effective management. In this scenario, option A, "old age," is the correct answer. This is because KD primarily affects children under 5 years old, and older age is not typically associated with poor outcomes in KD. Male gender (option B) is a known risk factor for KD but not a predictor of poor outcomes. Persistent fever (option C) is a common symptom in KD and is associated with the acute phase of the disease but not necessarily with poor outcomes. Poor response to intravenous immunoglobulin (IVIG) (option D) is a crucial predictor of poor outcome in KD as it indicates resistance to the primary treatment modality for the disease. Educationally, understanding predictors of poor outcomes in KD is crucial for nurses caring for pediatric patients. Recognizing these predictors can aid in early identification of high-risk patients, prompt intervention, and improved patient outcomes. Nurses must be adept at recognizing and interpreting clinical indicators to provide optimal care for children with KD.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D) cyberbullying. Witnessing violence, community violence, and media violence can indeed have detrimental effects on children, such as poor school performance, symptoms of anxiety and depression, and lower self-esteem. However, cyberbullying does not necessarily directly result from an increased impact of violence in the same way as the other effects mentioned. Children exposed to violence can experience difficulties in academic performance due to trauma and emotional distress. They may also develop symptoms of anxiety and depression as a result of the exposure to violence, affecting their mental health and overall well-being. Furthermore, witnessing violence can lower a child's self-esteem and sense of self-worth, impacting their confidence and social interactions. In an educational context, understanding the effects of violence on children is crucial for pediatric nurses to provide holistic care. By recognizing these potential impacts, healthcare professionals can better support children and families dealing with the consequences of violence exposure. It is important to address these issues proactively to promote the health and well-being of children in their care.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the characteristics of retinal hemorrhages caused by abusive head trauma (AHT) is crucial for early identification and intervention. The correct answer, D) various sizes, is not characteristic of retinal hemorrhages caused by AHT. Retinal hemorrhages in AHT are typically multiple, involve more than one layer of the retina, and are often located in the central region of the retina. Multiple retinal hemorrhages are indicative of non-accidental trauma due to the pattern and distribution they present. These hemorrhages are usually found in different layers of the retina, with some affecting the deeper layers. The central location of the hemorrhages is significant because it distinguishes them from other causes of retinal hemorrhages. Educationally, this question emphasizes the importance of recognizing specific patterns and characteristics of retinal hemorrhages in cases of suspected AHT. It highlights the necessity for healthcare providers to be vigilant in identifying subtle but critical signs that may indicate abuse in pediatric patients. Understanding these nuances can lead to early detection, appropriate reporting, and intervention to safeguard the well-being of children at risk of maltreatment.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) None of the above. The reason for this is that the infant in question is described as having normal growth and development, which indicates that the hyperbilirubinemia is likely physiological and not pathological. Physiological jaundice in newborns, especially breastfed infants, is common and typically resolves on its own without the need for treatment. Option A) Phototherapy is commonly used to treat hyperbilirubinemia, but in this case of physiological jaundice in a well-growing infant, it is not necessary as the bilirubin levels are not at a concerning level. Option B) Exchange transfusion is a more invasive and serious intervention reserved for severe cases of hyperbilirubinemia that are unresponsive to other treatments. This procedure is not indicated for a well newborn with physiological jaundice. Option C) Phenobarbital is sometimes used in cases of hyperbilirubinemia caused by specific conditions such as Crigler-Najjar syndrome, but it is not appropriate for physiological jaundice. From an educational perspective, it is crucial to understand the difference between physiological and pathological jaundice in newborns. Physiological jaundice is common, benign, and typically self-resolving, while pathological jaundice requires further investigation and potentially treatment. Understanding the context and characteristics of the infant's condition is essential in determining the appropriate management approach in pediatric nursing.