Features suggestive of minor manifestation of acute rheumatic fever include

Correct Answer: C

Rationale: In pediatric nursing, understanding the features of acute rheumatic fever is crucial for early recognition and appropriate management. The correct answer, option C, which is joint pain without any objective finding, is suggestive of a minor manifestation of acute rheumatic fever. This is because joint pain is a common symptom seen in acute rheumatic fever, especially in its early stages, and may precede the development of more obvious clinical signs. Option A, serological evidence of recent streptococcal infection, is more indicative of the etiology of acute rheumatic fever rather than a minor manifestation. It is an important diagnostic criterion but not a feature suggestive of a minor manifestation. Option B, a non-pruritic erythematous rash over the trunk with fading center and well margin, is more characteristic of erythema marginatum, a major manifestation of acute rheumatic fever, rather than a minor manifestation. Option D, involuntary purposeless, jerky dysthymic movement of hands and arms, describes chorea, which is another major manifestation of acute rheumatic fever and not a minor feature. Educationally, understanding the different manifestations of acute rheumatic fever is vital for nurses caring for pediatric patients. Recognizing minor manifestations can lead to early intervention and prevention of complications associated with acute rheumatic fever. By knowing the subtle signs and symptoms, nurses can advocate for appropriate diagnostic testing and treatment, ultimately improving patient outcomes.

Correct Answer: B

Rationale: In pediatric nursing, understanding cardiac auscultation findings is crucial for identifying and managing various congenital heart defects. In this case, the correct answer is B) Atrial septal defect (ASD). A wide fixed splitting of the second heart sound occurs in ASD due to the increased blood flow to the right side of the heart, causing a delay in the closure of the pulmonic valve. This delay results in the audible split sound that remains constant throughout the cardiac cycle. Option A) Pulmonary stenosis (PS) is incorrect because PS typically presents with a systolic ejection murmur and a delayed or paradoxical splitting of the second heart sound. Option C) Aortic stenosis (AS) is incorrect as it is associated with a systolic ejection murmur and a normal or paradoxical splitting of the second heart sound. Option D) Ventricular septal defect (VSD) is incorrect as VSD commonly presents with a harsh holosystolic murmur at the lower left sternal border and a normal splitting of the second heart sound. Educationally, identifying specific auscultatory findings aids in the accurate diagnosis of pediatric cardiac conditions. Nurses must be able to differentiate between various heart defects to provide prompt and appropriate care to pediatric patients with congenital heart diseases. Understanding the pathophysiology behind auscultatory findings enhances the nurse's assessment skills and contributes to improved patient outcomes.

Correct Answer: B

Rationale: In pediatric nursing, understanding the indicators of poor outcomes in fulminant hepatitis is crucial for providing optimal care. The correct answer is B) Factor VII <8% of normal. This is because a severe deficiency in Factor VII, a clotting factor synthesized by the liver, indicates significant liver dysfunction in fulminant hepatitis, leading to a poor prognosis. Option A) Increased prothrombin time response to vitamin K administration is incorrect because it suggests a deficiency in Vitamin K-dependent clotting factors, which is not specific to liver dysfunction in fulminant hepatitis. Option C) Female sex is incorrect as it is not a direct indicator of poor outcome in fulminant hepatitis. Gender alone does not determine the severity or outcome of the condition. Option D) Hepatomegaly is incorrect as it is a common physical finding in liver diseases but does not necessarily predict the outcome in fulminant hepatitis. Educationally, understanding these clinical indicators helps nurses in early recognition of deteriorating conditions in pediatric patients with fulminant hepatitis. It allows for prompt interventions and close monitoring to improve patient outcomes. Recognizing the significance of Factor VII levels can guide treatment strategies and help in the holistic management of children with this life-threatening condition.

Correct Answer: C

Rationale: In pediatric nursing, understanding the prevalence of biliary atresia and its association with neonatal cholestasis is crucial for early detection and intervention. The correct answer is C) 25% for the percentage of biliary atresia cases causing neonatal cholestasis. Rationale for C: Biliary atresia is a rare condition where the bile ducts are blocked or absent, leading to cholestasis in neonates. Research indicates that approximately 25% of cases of neonatal cholestasis are attributed to biliary atresia. This statistic highlights the importance of considering biliary atresia in the differential diagnosis of neonatal cholestasis to expedite treatment and improve outcomes. Rationale for others: A) 30% - This option is incorrect as the actual percentage is slightly lower at 25%. B) 40% - This percentage is higher than the actual prevalence of biliary atresia causing neonatal cholestasis. D) 70% - This option is significantly higher than the correct percentage, emphasizing the need for accurate knowledge in pediatric nursing practice. Educational context: In pediatric nursing, recognizing the signs and symptoms of biliary atresia and understanding its impact on neonatal cholestasis is essential for providing quality care to infants. By knowing the prevalence rates, nurses can advocate for timely diagnostic testing and interventions to support positive patient outcomes. This question underscores the significance of evidence-based practice and clinical reasoning in pediatric nursing.

Correct Answer: B

Rationale: In pediatric nursing, understanding congenital heart defects like ventricular septal defects (VSD) is crucial. The correct answer is B) Symptoms appear within 1-3 months. This is because large VSDs often lead to symptoms like poor feeding, failure to thrive, respiratory infections, and heart failure within the first few months of life due to the significant left-to-right shunting of blood. Option A) Right apical impulse is incorrect because in VSD, the apical impulse is usually displaced to the left due to left ventricular enlargement. Option C) Diastolic murmur is incorrect because VSD typically presents with a holosystolic murmur along the left sternal border due to the increased flow across the defect during systole. Option D) Normal pulmonary venous markings is incorrect because in large VSD, there may be increased pulmonary blood flow leading to pulmonary congestion and prominent pulmonary vascular markings on imaging. Educationally, understanding the characteristic signs and symptoms of large VSDs is vital for early identification and management in pediatric patients. Nurses need to be able to recognize these clinical manifestations to provide prompt interventions and prevent complications associated with untreated VSDs.