Cutaneous symptoms may be absent in anaphylaxis in

Correct Answer: C

Rationale: In anaphylaxis, cutaneous symptoms may be absent in approximately 20% of cases. This is because anaphylaxis is a systemic, severe allergic reaction that can present with a wide range of symptoms beyond just skin manifestations. The correct answer, option C (20%), reflects this fact. Option A (5%) is too low of a percentage, as anaphylaxis often involves more than just a small minority of cases without cutaneous symptoms. Option B (10%) is also too low, as it underestimates the frequency of anaphylaxis presentations without cutaneous involvement. Option D (30%) is too high, as cutaneous symptoms are absent in a smaller proportion of anaphylactic cases. Educationally, understanding the variability in anaphylaxis presentations is crucial for healthcare professionals, especially pediatric nurses. Being aware that cutaneous symptoms may be absent in a significant percentage of cases can prevent misdiagnosis or delayed treatment. Nurses play a key role in recognizing and managing anaphylaxis in pediatric patients, so having a comprehensive understanding of the condition is essential for providing safe and effective care.

Correct Answer: C

Rationale: Fixed drug eruption is a type of adverse drug reaction characterized by the development of well-demarcated erythematous patches that recur at the same site upon re-exposure to the causative agent. In this case, the correct answer is C) nonsteroidal anti-inflammatory drug (NSAID). NSAIDs are known to be common culprits in causing fixed drug eruptions due to their ability to induce a delayed hypersensitivity reaction in the skin upon re-exposure. The mechanism involves the activation of T-cells and subsequent release of inflammatory mediators leading to the characteristic skin lesions. Regarding the incorrect options: A) Allopurinol is associated with severe cutaneous adverse reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis, but not fixed drug eruptions. B) Cephalosporins are more commonly linked to immediate hypersensitivity reactions like urticaria or anaphylaxis rather than fixed drug eruptions. D) Nitrofurantoin is known to cause adverse effects like drug-induced lupus or pulmonary reactions, but not typically fixed drug eruptions. Educationally, understanding the specific drug etiologies of various adverse reactions is crucial for pediatric nurses to effectively assess, manage, and educate patients and families about potential risks associated with medications. Recognizing the signs and symptoms of fixed drug eruptions and knowing the common causative agents can aid in prompt identification and prevention of further exposure, ultimately improving patient outcomes.

Correct Answer: D

Rationale: The correct answer is D) Dennie-Morgan folds. Dennie-Morgan folds are the prominent creases under the lower eyelids seen in atopic children due to chronic itching and rubbing of the eyes. These folds are characteristic of atopic dermatitis and are a physical manifestation of the condition. Option A) Allergic salute refers to the upward rubbing of the nose seen in children with allergic rhinitis, not the creases under the lower eyelids. Option B) Allergic shiners are dark circles under the eyes caused by congestion of blood vessels due to allergies, not the creases under the lower eyelids. Option C) Pityriasis alba presents as pale patches on the skin, commonly on the face, and is not related to the creases under the lower eyelids in atopic children. Educational context: Understanding the physical manifestations of atopic dermatitis in children is crucial for pediatric nurses. Recognizing Dennie-Morgan folds can aid in early identification and management of atopic dermatitis, leading to better outcomes for pediatric patients. It is essential for nurses to be familiar with these clinical signs to provide comprehensive care to children with atopic conditions.

Correct Answer: C

Rationale: In pediatric nursing, understanding the appropriate use of medications, such as β2-agonists, is crucial for managing respiratory conditions like asthma. The correct answer, option C (8 puffs per day), indicates inadequate control when exceeded. This is because the need for frequent use of β2-agonists suggests that the patient's asthma is not well managed, and the condition is not under control. Option A (4 puffs per day) is too low of a threshold to indicate poor control. It is within the normal range for some patients with asthma who may require this dosage for effective symptom management. Option B (6 puffs per day) is also within a range that may be appropriate for some patients, depending on their individual asthma severity and treatment plan. Option D (10 puffs per day) is a high number of puffs that could indicate severe symptoms or exacerbation, rather than just poor control. At this level, it is more likely that the patient needs immediate medical attention or a change in their treatment plan. Educationally, understanding medication usage thresholds in pediatric patients with asthma is vital for nurses to assess and manage their care effectively. By recognizing the significance of β2-agonist overuse as a sign of inadequate control, nurses can intervene early to prevent worsening symptoms and improve the child's quality of life.

Correct Answer: D

Rationale: In this question about antihistamines and their effectiveness in treating symptoms, the correct answer is D) nasal congestion. Antihistamines work by blocking the action of histamine, a chemical released by the immune system during an allergic reaction. Histamine is responsible for symptoms like sneezing, rhinorrhea (runny nose), and ocular itching. However, nasal congestion is primarily caused by inflammation and swelling of the nasal passages, which are not directly mediated by histamine. Option A) sneezing, Option B) rhinorrhea, and Option C) ocular itching are all symptoms that are typically responsive to antihistamines because they are directly linked to histamine release in the body during an allergic response. Sneezing and runny nose are common symptoms of allergies, and ocular itching is often associated with allergic conjunctivitis. In an educational context, this question highlights the importance of understanding the mechanisms of action of medications in treating specific symptoms. It emphasizes the need for healthcare professionals, such as pediatric nurses, to have a thorough knowledge of pharmacology to provide effective care and make appropriate treatment decisions for pediatric patients with allergies or other conditions requiring antihistamine therapy. By understanding which symptoms are likely to respond to antihistamines, nurses can better assess and manage pediatric patients with allergic conditions.