Clinical examination of a child with large unilateral pneumothorax can show:

Correct Answer: A

Rationale: In a child with a large unilateral pneumothorax, the clinical examination can show decreased breath sound intensity, making option A the correct answer. This occurs because air accumulation in the pleural space hinders normal lung sounds from reaching the chest wall. Option B, increased tactile vocal fremitus, is incorrect because tactile fremitus typically decreases or remains unchanged in a pneumothorax due to the presence of air rather than fluid or solid material in the pleural space. Option C, crepitations, are more commonly associated with conditions like pneumonia or pulmonary edema, not pneumothorax. Option D, bronchial breathing, is characterized by harsh, tubular breath sounds heard over a consolidated lung area, which is not typically present in a pneumothorax unless there are other underlying conditions. Educationally, understanding the clinical manifestations of pneumothorax in children is crucial for pediatric nursing practice. Recognizing the signs and symptoms of pneumothorax, such as decreased breath sounds, enables early detection and timely interventions to prevent respiratory compromise and other potential complications.

Correct Answer: D

Rationale: The correct answer is D) Post auricular lymphadenopathy. Rubella, also known as German measles, is characterized by the presence of post auricular lymphadenopathy, which refers to swollen lymph nodes located behind the ears. This clinical sign is pathognomonic, meaning it is highly characteristic and specific to rubella. Option A) Severe prodromal stage is not pathognomonic of rubella. While rubella does have a prodromal stage, the severity of this stage is not unique to rubella and can be seen in other conditions as well. Option B) Circumoral pallor is not specific to rubella. This finding refers to a paleness around the mouth and is not a key clinical sign of rubella. Option C) Maculopapular rash is a common manifestation of rubella but is not pathognomonic. This type of rash can be seen in various viral infections and is not unique to rubella. Educationally, understanding the key clinical signs and symptoms of pediatric diseases like rubella is crucial for nurses caring for pediatric patients. Recognizing pathognomonic signs can lead to early identification and appropriate management of the condition, ultimately improving patient outcomes. Nurses should be well-versed in differentiating between common and unique clinical manifestations to provide optimal care to their pediatric patients.

Correct Answer: A

Rationale: Acyclovir is indicated for the treatment of herpes simplex virus infections. This antiviral medication specifically targets and inhibits the replication of herpes simplex virus types 1 and 2. Herpes simplex virus infections commonly manifest as oral or genital lesions and acyclovir is effective in reducing the severity and duration of these symptoms. Option B) Enteroviruses: Acyclovir is not effective against enteroviruses as it specifically targets herpes simplex viruses. Enteroviruses can cause a variety of illnesses such as hand, foot, and mouth disease, meningitis, and myocarditis. Option C) Mumps: Acyclovir is not indicated for the treatment of mumps. Mumps is caused by a different virus and does not respond to acyclovir treatment. Option D) Measles: Acyclovir is not used to treat measles. Measles is caused by a different virus and requires a different treatment approach. Understanding the indications for specific medications is crucial in pediatric nursing practice to ensure safe and effective patient care. Knowing the appropriate use of medications like acyclovir can help pediatric nurses provide optimal treatment for their young patients with herpes simplex virus infections.

Correct Answer: D

Rationale: The correct answer is D) Large atrial septal defect (ASD). A mid-diastolic rumble murmur at the lower left sternal border is characteristic of ASD. This murmur occurs due to increased flow across the tricuspid valve during diastole, leading to turbulence. Option A) Large PDA usually presents with a continuous murmur, not a mid-diastolic rumble. Option B) Severe mitral incompetence typically causes a holosystolic murmur, not a mid-diastolic rumble. Option C) Aortic rheumatic carditis with mitral valvulitis would manifest with different murmurs associated with valvular dysfunction, not a mid-diastolic rumble. Educationally, it is crucial for pediatric nurses to understand the specific characteristics of murmurs associated with different structural heart diseases to accurately assess and diagnose pediatric patients. Recognizing the unique features of each murmur can guide appropriate interventions and referrals for further evaluation and treatment.

Correct Answer: D

Rationale: In pediatric nursing, understanding blood pressure (BP) ranges and classifications is crucial for early detection and management of hypertension. Stage 1 hypertension in children is defined as average SBP or DBP levels between the 95th and 99th percentile for age, sex, and height on multiple occasions. This means the correct answer is D. Option A (average SBP or DBP levels <90th percentile) is incorrect because this range is considered normal BP in children. Option B (average SBP or DBP levels > 99th percentile) is incorrect as it would indicate severe hypertension. Option C (BP > 120/80) is not specific to pediatric hypertension criteria. Educationally, this question highlights the importance of accurate BP measurements in children and the need to interpret them based on age-specific percentiles. Understanding these classifications helps nurses identify and intervene early in hypertension cases, preventing long-term cardiovascular complications. Regular monitoring, proper technique, and knowledge of pediatric BP norms are essential skills for pediatric nurses.