Bronchodilator response to an inhaled B-agonist (e.g., albuterol) is greater in asthmatic patients than in non-asthmatic persons. The rate of improvement in FEV1 consistent with asthma is

Correct Answer: D

Rationale: In the context of asthma, bronchodilator response to an inhaled B-agonist like albuterol is a key diagnostic tool. The correct answer, option D (>15%), is indicative of a significant improvement in forced expiratory volume in 1 second (FEV1) after bronchodilator administration, which is consistent with asthma. Asthmatic patients typically show a greater response to bronchodilators due to the bronchoconstriction present in their airways. Options A, B, and C are incorrect because they suggest lower rates of improvement in FEV1. A response of less than 15% would not be considered significant in the context of asthma diagnosis. Understanding the specific thresholds for bronchodilator response is crucial for healthcare providers in diagnosing and managing asthma in pediatric patients. Educationally, this question highlights the importance of recognizing the characteristic bronchodilator response seen in asthmatic patients. It reinforces the need for healthcare professionals to interpret pulmonary function test results accurately to guide appropriate treatment decisions for pediatric patients with asthma. By understanding the significance of bronchodilator response rates, nurses and other healthcare providers can better assess, manage, and educate pediatric patients and their families about asthma management strategies.

Correct Answer: C

Rationale: In pediatric nursing, it is essential to understand the appropriate management of skin conditions like impetigo in patients with atopic dermatitis. The correct choice of antibiotic in treating localized impetiginous lesions in these patients is topical mupirocin (Option C). Here's the rationale: Topical mupirocin is the best choice because it is effective against the most common pathogens causing impetigo, such as Staphylococcus aureus and Streptococcus pyogenes. It provides targeted treatment to the affected area, minimizing systemic effects and reducing the risk of antibiotic resistance. Oral erythromycin (Option A) is less effective against the bacteria commonly involved in impetigo. Oral cephalexin (Option B) may be more appropriate for deeper skin infections but is not the first-line treatment for impetigo. Topical ampicillin (Option D) is not a recommended treatment for impetigo due to its limited spectrum of activity and the availability of more effective alternatives like mupirocin. Educationally, understanding the rationale behind antibiotic choices in pediatric dermatology is crucial for providing safe and effective care to patients. It highlights the importance of evidence-based practice and tailoring treatment to the specific characteristics of each case, promoting better outcomes and minimizing adverse effects.

Correct Answer: B

Rationale: In pediatric nursing, understanding the differences between stinging insects is crucial for patient safety and care. The correct answer is B) yellow jackets. Yellow jackets are considered the most notorious stinging insect due to their aggressive nature and ability to sting repeatedly. This is important to know in a pediatric setting as these stings can lead to severe allergic reactions in some children. The other options are not the most notorious stinging insect for various reasons: A) Honeybees typically sting only once and are less aggressive compared to yellow jackets. C) Hornets can be aggressive but are not as common or notorious for stinging as yellow jackets. D) Bumblebees are generally docile and unlikely to sting unless provoked, making them less notorious than yellow jackets. Educationally, understanding the differences between these insects helps pediatric nurses provide appropriate care in case of stings. Recognizing the most notorious stinging insect allows for prompt and effective intervention, especially in cases of allergic reactions. This knowledge is essential for ensuring the safety and well-being of pediatric patients in various environments.

Correct Answer: B

Rationale: In pediatric nursing, understanding ocular allergies is crucial for providing optimal care to young patients. The correct answer is B) vernal keratoconjunctivitis. This type of ocular allergy is the most sight-threatening because it can lead to serious complications such as corneal ulcers and vision impairment if left untreated. Vernal keratoconjunctivitis is a chronic, severe allergic conjunctivitis that primarily affects children and adolescents with a family history of allergies. Option A) contact allergy is not the most sight-threatening type of ocular allergy. While contact allergies can cause discomfort and irritation, they are typically localized and do not pose significant risks to vision compared to vernal keratoconjunctivitis. Option C) giant papillary conjunctivitis is characterized by inflammation of the conjunctiva due to chronic irritation, often caused by contact lens wear. While it can lead to discomfort and blurred vision, it is not considered as sight-threatening as vernal keratoconjunctivitis. Option D) seasonal allergic conjunctivitis refers to allergic reactions triggered by seasonal allergens such as pollen. While it can cause significant discomfort and affect quality of life, it is generally less severe and sight-threatening compared to vernal keratoconjunctivitis. Educationally, understanding the different types of ocular allergies and their respective risks is essential for pediatric nurses to accurately assess and manage ocular conditions in young patients. Recognizing the severity of vernal keratoconjunctivitis highlights the importance of early identification and appropriate treatment to prevent long-term complications and preserve vision.

Correct Answer: D

Rationale: In the case of chronic urticaria, the correct answer is option D) cutaneous blistering disorders. The reason this is the correct answer is that chronic urticaria is characterized by hives or wheals on the skin that are typically associated with itching and can be caused by various factors such as allergies, infections, or autoimmune diseases. Cutaneous blistering disorders, on the other hand, present with blisters on the skin, which is a different clinical manifestation than urticaria. Option A) cutaneous mastocytosis and option B) systemic mastocytosis are both types of mast cell disorders that can present with skin manifestations similar to urticaria. Mastocytosis involves an abnormal accumulation of mast cells in the skin and other organs, leading to symptoms like hives, itching, and flushing, which can be mistaken for urticaria. Option C) complement-mediated mast cell degranulation in malignancies is a rare condition where certain cancers can trigger mast cell degranulation through the complement system, leading to symptoms similar to urticaria. This option is included in the list of differentials for chronic urticaria because it highlights the importance of considering underlying malignancies in patients presenting with chronic skin symptoms. In an educational context, understanding the differential diagnosis of chronic urticaria is crucial for nurses caring for pediatric patients. By differentiating between various conditions that can mimic urticaria, nurses can provide appropriate care, treatment, and referrals for pediatric patients with skin manifestations. This knowledge helps in accurate assessment, diagnosis, and management of pediatric patients with skin conditions, improving patient outcomes and quality of care.