All the following are features of childhood SLE EXCEPT

Correct Answer: C

Rationale: In pediatric nursing, understanding systemic lupus erythematosus (SLE) in children is crucial due to its impact on their health. The correct answer, option C, "it usually presents before 5 years of age," is correct because childhood SLE typically presents in late childhood or adolescence, unlike adult-onset SLE. Option A, "it has a more severe course," is incorrect because childhood SLE generally has a milder course compared to adult SLE. Option B, "there is more widespread organ involvement," is incorrect as childhood SLE tends to involve fewer organs than adult SLE. Option D, "fever, fatigue, hematologic abnormalities, and arthritis are common clinical manifestations," is incorrect as these are common manifestations in both childhood and adult SLE. Educationally, knowing the differences in SLE presentation in children versus adults is vital for accurate diagnosis and management. Understanding these distinctions can help pediatric nurses provide appropriate care, support families, and advocate for children with SLE effectively. This knowledge enhances the quality of care provided to pediatric patients with autoimmune conditions like SLE.

Correct Answer: A

Rationale: In the context of Kawasaki disease (KD), predicting poor outcomes is crucial for timely intervention and management. In this case, option A (old age) is the correct answer as it is not a predictor of poor outcome in KD. Older age is not typically associated with worse outcomes in KD, unlike in other conditions where age can be a significant factor. Male gender (option B) is a known risk factor for coronary artery abnormalities in KD. Persistent fever (option C) is a key clinical feature of KD and can indicate ongoing inflammation and risk of complications. Poor response to IVIG (option D) is a concerning sign as IVIG is a primary treatment for KD; failure to respond may indicate more severe disease and higher risk of poor outcomes. In an educational setting, understanding predictors of poor outcomes in KD is essential for nurses caring for pediatric patients. By recognizing these factors, nurses can monitor patients closely, advocate for timely interventions, and communicate effectively with the healthcare team to ensure the best possible outcomes for children with KD.

Correct Answer: D

Rationale: The correct answer is D) cyberbullying. Witnessing violence, whether in the community or through media, can have significant negative effects on children's mental and emotional well-being. When children are exposed to violence, they are at risk of experiencing poor school performance, symptoms of anxiety and depression, and lower self-esteem. These adverse effects stem from the trauma and distress caused by witnessing violence, which can impact a child's ability to focus on academics, lead to emotional disturbances, and erode their sense of self-worth. Cyberbullying, while also a serious issue affecting children today, is not directly related to the increased impact of violence on children. Cyberbullying typically occurs in the digital realm and is more closely linked to interpersonal conflicts, online behavior, and social dynamics among peers. While exposure to violence can certainly exacerbate existing vulnerabilities and contribute to a child's susceptibility to cyberbullying, it is not a direct consequence of the increased impact of violence. In an educational context, it is important for healthcare providers, educators, and caregivers to be aware of the detrimental effects of violence on children's well-being. By understanding how exposure to violence can manifest in various forms of distress and impairment, professionals can intervene early to provide appropriate support and resources for affected children. Recognizing the signs and symptoms of trauma and addressing the underlying causes are crucial steps in promoting the mental health and resilience of children in the face of violence.

Correct Answer: D

Rationale: In pediatric nursing, understanding the significance of retinal hemorrhages as a marker of abusive head trauma (AHT) is crucial for early detection and intervention. The correct answer, D) various sizes, is not characteristic of retinal hemorrhages caused by AHT. Retinal hemorrhages in AHT typically present as multiple, involving more than one layer of the retina, and often have a central location due to the shearing forces on the retinal layers. Option A) multiple is correct because retinal hemorrhages in AHT are often seen in multiple locations within the retina. Option B) involving more than one layer of the retina is correct as AHT-related hemorrhages can affect multiple layers due to the severity of the trauma. Option C) central is also correct because central or perimacular hemorrhages are common findings in AHT cases. Educationally, understanding the specific characteristics of retinal hemorrhages in AHT is vital for nurses and healthcare providers working with pediatric patients. Recognizing these signs can prompt further investigation and appropriate reporting to safeguard the well-being of the child. By differentiating these findings from other causes of retinal hemorrhages, healthcare professionals can contribute to the timely identification and intervention in cases of suspected abuse.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) None of the above. The management of hyperbilirubinemia in a term, breast-fed infant with normal growth and development involves close monitoring, supportive care, and addressing the underlying cause. Option A) Phototherapy is a common treatment for hyperbilirubinemia, but in this case where the infant is healthy with normal growth and development, immediate phototherapy may not be necessary as long as bilirubin levels are not excessively high. Option B) Exchange transfusion is a more aggressive treatment reserved for severe cases of hyperbilirubinemia or when phototherapy fails. It is not indicated in this scenario where the infant is well and thriving. Option C) Phenobarbital is not typically used to treat hyperbilirubinemia in newborns. It is more commonly used for conditions such as seizures. In an educational context, it is important for healthcare providers to individualize care based on the specific needs of each infant. Understanding the nuances of managing hyperbilirubinemia in newborns, including when to intervene and when to monitor closely, is crucial for providing safe and effective care. In this case, the infant's normal growth and development indicate that no immediate intervention is necessary, and ongoing monitoring is sufficient.