Anaphylactic reactions after a Hymenoptera sting are treated exactly like anaphylaxis from any cause. Of the following, the drug of choice is

Correct Answer: B

Rationale: In the management of anaphylactic reactions, especially those caused by Hymenoptera stings, epinephrine is the drug of choice. Epinephrine acts quickly to reverse the life-threatening symptoms of anaphylaxis by constricting blood vessels, increasing heart rate, opening airways, and reducing swelling. This rapid action is crucial in preventing severe complications and potential fatality. Oxygen (Option A) is important in supporting respiratory function during anaphylaxis but is not the primary treatment. Antihistamines (Option C) may help relieve itching and hives but do not address the severe cardiovascular and respiratory effects of anaphylaxis. Corticosteroids (Option D) have a delayed onset of action and are not considered first-line treatment for acute anaphylaxis. In an educational context, understanding the importance of prompt and effective treatment for anaphylaxis is vital for healthcare providers, especially pediatric nurses. Recognizing the signs and symptoms of anaphylaxis, knowing the appropriate interventions, and being able to quickly administer epinephrine can save lives in pediatric emergencies. It is essential for nurses to be well-versed in evidence-based practices to ensure positive patient outcomes.

Correct Answer: C

Rationale: In the context of pediatric nursing and anaphylaxis, it is crucial to understand the presentation of symptoms to provide timely and effective care to children. The correct answer, option C) 20%, is the most appropriate choice because anaphylaxis can present with cutaneous symptoms being absent in approximately 20% of cases. This fact highlights the variability in symptomatology that can occur during an anaphylactic reaction, emphasizing the need for healthcare providers to consider a wide range of possible presentations in pediatric patients. Options A) 5%, B) 10%, and D) 30% are incorrect because they do not accurately reflect the percentage of anaphylactic cases where cutaneous symptoms may be absent. Understanding this specific percentage is crucial in pediatric nursing practice to avoid overlooking potential cases of anaphylaxis that may present without typical skin manifestations like hives or rash. Educationally, this question serves to reinforce the importance of comprehensive knowledge in pediatric nursing, particularly in recognizing and managing life-threatening conditions like anaphylaxis. By understanding the nuances of symptom presentation, nurses can enhance their clinical assessment skills and provide prompt interventions to pediatric patients experiencing allergic reactions. This question underscores the need for pediatric nurses to maintain a high level of vigilance and proficiency in handling emergent situations in pediatric care settings.

Correct Answer: C

Rationale: In this question from the Pediatric Nurse Exam Sample Questions, the correct answer is C) shellfish. The rationale behind this is that shellfish allergies typically have a later onset of presentation compared to other common allergens. Shellfish allergies often manifest later in childhood or even in adulthood, whereas allergies to substances like hen's egg white, peanuts, and soybean tend to present earlier in life. This is important for pediatric nurses to recognize, as the timing of onset can impact diagnosis, management, and education for both the patient and their caregivers. Hen's egg white and peanuts are known to be common allergens in young children, often presenting early in infancy or toddlerhood. Soybean allergies are also typically identified early in life. Understanding the typical onset of these allergens can help healthcare providers differentiate and diagnose food allergies more effectively. Educationally, this question highlights the importance of recognizing the variability in onset times for different food allergies. By understanding these patterns, pediatric nurses can better assess, diagnose, and manage food allergies in their young patients, ultimately improving outcomes and quality of care.

Correct Answer: C

Rationale: Fixed drug eruption is a localized cutaneous reaction that occurs in response to a specific medication. In this case, the correct answer is C) nonsteroidal anti-inflammatory drug (NSAID). NSAIDs, such as ibuprofen or naproxen, are known to cause fixed drug eruptions in some individuals. These eruptions typically appear as round or oval erythematous patches on the skin. Option A) allopurinol is commonly associated with severe cutaneous adverse reactions like Stevens-Johnson syndrome or toxic epidermal necrolysis, not fixed drug eruptions. Option B) cephalosporins are more commonly linked to allergic reactions like hives or anaphylaxis rather than fixed drug eruptions. Option D) nitrofurantoin is known to cause drug-induced lupus or pulmonary reactions but is not a common culprit for fixed drug eruptions. Educationally, understanding the specific skin reactions caused by different medications is crucial for healthcare professionals, especially pediatric nurses, as they need to recognize and manage adverse drug reactions in children effectively. Recognizing the characteristic presentation of fixed drug eruptions can aid in prompt identification and appropriate management, such as discontinuing the offending medication and providing symptomatic relief.

Correct Answer: D

Rationale: The correct answer is D) Dennie-Morgan folds. Dennie-Morgan folds are prominent creases under the lower eyelids commonly seen in atopic children. These folds are a physical manifestation of atopic dermatitis, which is a chronic inflammatory skin condition often associated with allergies. Recognizing Dennie-Morgan folds is important in pediatric nursing as they can indicate the presence of atopic dermatitis and help guide treatment and management strategies. Option A) Allergic salute refers to a child's habit of rubbing their nose upward with the palm of their hand due to nasal congestion from allergies. This is not related to the creases under the lower eyelids. Option B) Allergic shiners are dark circles or discoloration under the eyes often seen in children with allergies. While they are related to allergies, they are not the same as Dennie-Morgan folds. Option C) Pityriasis alba is a common skin condition characterized by pale, scaly patches on the face, especially in children with darker skin tones. This is unrelated to the creases under the lower eyelids seen in atopic children. Understanding these physical signs associated with atopic dermatitis and allergies is crucial for pediatric nurses to provide comprehensive care to their patients. By correctly identifying Dennie-Morgan folds, nurses can work with healthcare providers to develop appropriate treatment plans and educate families on managing atopic conditions effectively.