Daily long-term control therapy is recommended for infants and young children (0-4 years) who had in the previous year

Correct Answer: B

Rationale: The correct answer is B) three or more episodes of wheezing that lasted more than 1 day. Daily long-term control therapy is recommended for infants and young children in this age group who have had three or more episodes of wheezing in the previous year. This is based on the guidelines for managing asthma in children, where persistent wheezing indicates the need for long-term control therapy to prevent exacerbations and maintain optimal lung function. Option A) two or more episodes of wheezing is incorrect because the guideline specifies three or more episodes as the threshold for initiating daily long-term control therapy. Option C) four or more episodes and Option D) five or more episodes exceed the recommended threshold and would lead to unnecessary treatment in children who do not meet the criteria for daily therapy. Educationally, it is important for pediatric clinical nurse specialists to understand the criteria for initiating long-term control therapy in young children with asthma to provide appropriate and evidence-based care. Recognizing the appropriate indications for treatment can help prevent unnecessary medication use and improve outcomes for pediatric patients with asthma.

Correct Answer: A

Rationale: In the management of urticaria and angioedema, avoidance of triggering agents is essential to prevent exacerbations. The mainstay of pharmacologic treatment for these conditions is second-generation H1 antihistamines, making option A the correct choice. Second-generation H1 antihistamines, such as loratadine, cetirizine, and fexofenadine, are preferred due to their decreased sedative effects compared to first-generation antihistamines. They work by blocking the action of histamine, which is responsible for the symptoms of urticaria and angioedema. Tricyclic antidepressants (option B) are not recommended as first-line treatment for urticaria and angioedema. They may be considered in some cases for their antihistaminic effects, but their side effect profile and potential for drug interactions make them less favorable. Corticosteroids (option C) are not typically used as the mainstay treatment for urticaria and angioedema due to their potential for long-term adverse effects and limited efficacy in these conditions. Leukotriene receptor blockers (option D) are more commonly used in conditions like asthma and allergic rhinitis, but they are not considered first-line treatment for urticaria and angioedema. In an educational context, understanding the appropriate pharmacologic management of urticaria and angioedema is crucial for pediatric clinical nurse specialists to provide optimal care to their patients. By recognizing the mainstay of treatment and the rationale behind it, nurses can effectively manage these conditions and improve patient outcomes.

Correct Answer: B

Rationale: The correct answer is B) Deliver a correction bolus of rapid-acting insulin via an insulin syringe or pen. In this scenario, the 14-year-old girl with type 1 diabetes is experiencing hyperglycemia and ketones despite insulin pump therapy, indicating a need for immediate correction of blood glucose levels. Administering a rapid-acting insulin bolus via syringe or pen allows for a quicker response compared to waiting for the insulin pump to deliver the correction dose. This method helps to address the current high blood glucose levels and ketones more effectively. Option A) Deliver a correction bolus of rapid-acting insulin through the insulin pump is less ideal in this situation due to the urgency of the high blood glucose and ketones. The pump may take longer to deliver the insulin compared to using a syringe or pen. Option C) Deliver a dose of long-acting insulin is not appropriate for addressing acute hyperglycemia and ketones. Long-acting insulin is used for basal insulin coverage and would not provide the rapid correction needed in this case. Option D) Perform 30 minutes of exercise and drink 500 mL of water is not recommended as the primary intervention for treating hyperglycemia and ketones in this scenario. While exercise and hydration are important aspects of diabetes management, they should not replace the need for immediate insulin correction. In an educational context, it is crucial for pediatric clinical nurse specialists to understand the urgency of addressing hyperglycemia and ketones in children with type 1 diabetes. This case highlights the importance of timely and appropriate insulin administration to prevent complications associated with uncontrolled blood glucose levels. Educating healthcare providers on the proper management of acute diabetes-related issues is essential for ensuring the well-being of pediatric patients with diabetes.

Correct Answer: C

Rationale: The correct answer is C) 10 days. Platelets are small, disc-shaped cell fragments that play a crucial role in blood clotting. The average lifespan of platelets in circulation is approximately 7-10 days. This is an important fact for pediatric clinical nurse specialists to understand as it impacts patient care, especially in cases of bleeding disorders or thrombocytopenia. Option A) 24 hours is incorrect because platelets typically last longer in circulation than just one day. Option B) 72 hours is also incorrect as it falls within the range of platelet lifespan, but the average is closer to 10 days. Option D) 30 days is too long for the lifespan of platelets; they are typically cleared from circulation before reaching 30 days. Understanding the lifespan of platelets is crucial for nurses working with pediatric patients who may require monitoring of their platelet counts and function. This knowledge helps in assessing and managing bleeding disorders, ensuring appropriate interventions are implemented, and promoting optimal patient outcomes.

Correct Answer: A

Rationale: In this scenario, the most appropriate therapy for a 12-year-old with repeated episodes of streptococcal pharyngitis experiencing another sore throat episode is epinephrine (Option A). Epinephrine is the correct choice because it is a vasoconstrictor that helps to reduce inflammation in the throat, providing relief from the symptoms of streptococcal pharyngitis. It can help to decrease swelling, redness, and pain associated with the infection. Prednisone (Option B) is a corticosteroid that may be used in some cases to reduce inflammation, but it is not typically the first-line treatment for streptococcal pharyngitis. Diphenhydramine (Benadryl) (Option C) is an antihistamine that can help with allergies and itching but is not effective in treating the bacterial infection caused by streptococcal pharyngitis. Cimetidine (Option D) is a histamine H2-receptor antagonist used to reduce stomach acid production and treat ulcers, and it is not indicated for the treatment of streptococcal pharyngitis. In an educational context, it is important to understand the appropriate pharmacological treatments for common pediatric conditions like streptococcal pharyngitis. Understanding the rationale behind each treatment option helps healthcare providers make informed decisions to provide the best care for their pediatric patients.