In atopic dermatitis, the presence of punched-out erosions, vesicles, and infected skin lesions that fail to respond to oral antibiotics suggests infection with

Correct Answer: B

Rationale: In atopic dermatitis, the presence of punched-out erosions, vesicles, and infected skin lesions that do not respond to oral antibiotics suggests an infection with Herpes simplex. Herpes simplex virus can cause a severe infection in patients with compromised skin integrity due to atopic dermatitis. The virus can lead to painful vesicles and erosions that are often difficult to manage with conventional antibiotics. Option A) Herpes zoster typically presents as a painful rash in a dermatomal distribution and is not commonly associated with atopic dermatitis. Option C) Cutaneous warts are caused by human papillomavirus and present as raised, rough growths on the skin, not as punched-out erosions or vesicles. Option D) Trichophyton rubrum is a fungus responsible for causing dermatophytosis (ringworm) and does not typically present with the described features of punched-out erosions and vesicles in atopic dermatitis. In a pediatric nursing context, understanding the differential diagnosis of skin conditions is crucial for providing effective care to children. Recognizing the signs and symptoms of various infections helps nurses and healthcare providers make accurate diagnoses and implement appropriate treatment strategies promptly. This knowledge ensures optimal outcomes for pediatric patients with skin conditions such as atopic dermatitis.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding the etiology of chronic urticaria is crucial for providing effective care to children. The correct answer is B) systemic lupus erythematosus. Chronic urticaria is a condition characterized by persistent hives lasting more than 6 weeks. In children, systemic lupus erythematosus, an autoimmune disease, can manifest with chronic urticaria as a skin manifestation. This association underscores the importance of considering underlying systemic conditions in the differential diagnosis of chronic urticaria in pediatric patients. Option A) latex is incorrect because while latex allergy can cause acute urticaria, it is less commonly associated with chronic urticaria. Option C) IV immunoglobulin is incorrect as it is often used in the treatment of some autoimmune conditions but is not a common cause of chronic urticaria. Option D) streptococcal pharyngitis is incorrect as it is more likely to present with acute urticaria as a result of an infectious process rather than chronic urticaria. Educationally, understanding the various causes of chronic urticaria in pediatric patients is essential for nurses to provide comprehensive care. By grasping the link between systemic lupus erythematosus and chronic urticaria, nurses can advocate for timely assessments and interventions to address the underlying autoimmune process. This knowledge equips nurses with the ability to collaborate effectively with healthcare teams to ensure accurate diagnosis and management of pediatric patients presenting with chronic urticaria.

Correct Answer: D

Rationale: The correct answer is D) plasma tryptase. Plasma tryptase is the best diagnostic test for anaphylaxis in a child due to its specificity and sensitivity in detecting mast cell activation, which is a key feature of anaphylaxis. Tryptase levels rise early during an anaphylactic reaction and can remain elevated for several hours, making it a reliable marker to confirm the diagnosis. Option A) plasma histamine is not as specific for anaphylaxis as tryptase. Histamine levels can be affected by various factors and may not always correlate with the severity of an allergic reaction. Option B) skin tests are used to identify specific allergens triggering allergic reactions, but they are not diagnostic for anaphylaxis itself. Option C) radioallergosorbent assay (RAST) is a blood test that measures the amount of specific IgE antibodies to particular allergens. While useful for identifying triggers for allergic reactions, it is not specific for diagnosing anaphylaxis. In an educational context, understanding the most appropriate diagnostic tests for anaphylaxis is crucial for pediatric nurses to provide prompt and accurate care to children experiencing severe allergic reactions. Knowledge of specific markers like plasma tryptase can guide clinical decision-making and help in initiating timely interventions to manage anaphylaxis effectively.

Correct Answer: D

Rationale: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated gastrointestinal food hypersensitivity that primarily affects infants and young children. The correct answer, D, "commonly improved with ingestion of soy protein-based formula," is correct because FPIES is commonly triggered by cow's milk or soy proteins. However, using a soy protein-based formula can worsen symptoms in these patients. Option A, "manifests in the first months of life," is a characteristic feature of FPIES as symptoms typically present in infancy. Option B, "vomiting occurs 1-3 hours after feeding," is also a common presentation of FPIES, with delayed onset vomiting being a hallmark symptom. Option C, "hypotension occurs in approximately 15% of cases," is incorrect as hypotension is not a common feature of FPIES; dehydration due to vomiting is more common. Educationally, it is crucial to understand the distinguishing features of FPIES to provide appropriate care and support to affected children and their families. Recognizing the symptoms, triggers, and appropriate management strategies, such as eliminating the offending food proteins, is essential in the nursing care of pediatric patients with FPIES. Additionally, highlighting the potential risks of alternative formulas, like soy-based formulas in FPIES, underscores the importance of accurate nutritional management in these cases.

Correct Answer: D

Rationale: Allopurinol is a medication commonly used to treat gout and high levels of uric acid in the blood. It is known to cause allergic reactions in some individuals. In this case, the correct answer is D) pulmonary fibrosis, as this condition is not typically associated with allopurinol use. Option A) exanthem, B) Stevens-Johnson syndrome, and C) toxic epidermal necrolysis are all known potential allergic reactions to allopurinol. Exanthem refers to a widespread rash, while Stevens-Johnson syndrome and toxic epidermal necrolysis are severe skin conditions that can be life-threatening. In an educational context, it is crucial for healthcare professionals, especially pediatric nurses, to be aware of potential adverse reactions to medications commonly used in children. Understanding the possible allergic reactions to allopurinol can help nurses in monitoring and managing pediatric patients who are prescribed this medication. By knowing which reactions are associated with allopurinol use, nurses can provide safe and effective care to their young patients.