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 pediatric nursing, understanding atopic dermatitis is crucial as it is a common skin condition in children. The correct answer is B) Herpes simplex. Atopic dermatitis is a chronic inflammatory skin condition that can lead to skin barrier dysfunction, making individuals more susceptible to infections like herpes simplex. Herpes simplex can present with punched-out erosions, vesicles, and infected skin lesions in atopic dermatitis patients. Option A) Herpes zoster is incorrect because it typically presents as a painful rash in a dermatomal distribution, not as described in the question. Option C) cutaneous warts are caused by human papillomavirus and have a different appearance from the described lesions. Option D) Trichophyton rubrum is a fungus causing dermatophytosis, not the infection described in the question. Educationally, recognizing the clinical manifestations of different skin conditions in pediatric patients is essential for accurate diagnosis and management. Understanding the specific characteristics of infections like herpes simplex in the context of atopic dermatitis helps nurses provide appropriate care and treatment for pediatric patients with skin issues.

Correct Answer: B

Rationale: The correct answer is B) systemic lupus erythematosus. Chronic urticaria refers to hives that persist for more than 6 weeks and can be associated with underlying systemic conditions like autoimmune diseases. Systemic lupus erythematosus is a common autoimmune disorder that can manifest with chronic urticaria due to the immune system's dysregulation. Option A) latex is a common allergen that can cause acute urticaria but is less likely to be the cause of chronic urticaria. Option C) IV immunoglobulin is a treatment for certain immune deficiencies and autoimmune diseases but is not a common cause of chronic urticaria. Option D) streptococcal pharyngitis is an infection caused by streptococcus bacteria and is more likely to present with symptoms like sore throat and fever, rather than chronic urticaria. In the context of pediatric nursing, understanding the underlying causes of chronic urticaria is essential for providing comprehensive care to pediatric patients. Recognizing systemic conditions like systemic lupus erythematosus as a potential cause of chronic urticaria can aid in timely diagnosis and management, improving the overall health outcomes for pediatric patients.

Correct Answer: D

Rationale: In the context of pediatric nursing and diagnosing anaphylaxis in a child, the best diagnostic test for a child exposed to an allergen 3 hours before arriving at the hospital is plasma tryptase (option D). Plasma tryptase is the most reliable test for diagnosing anaphylaxis because it is a marker that is elevated during an acute allergic reaction. Tryptase levels rise quickly after the onset of anaphylaxis, making it a valuable tool in confirming the diagnosis in a child who presents with symptoms after allergen exposure. The other options are not the best diagnostic tests for anaphylaxis in this scenario. A) Plasma histamine levels can be elevated in anaphylaxis, but they are less specific and can fluctuate, making them less reliable for diagnosis. B) Skin tests are useful for identifying allergens that may trigger anaphylaxis in the future, but they are not typically used in the acute setting to diagnose anaphylaxis. C) Radioallergosorbent assay (RAST) is a blood test that measures IgE antibodies to specific allergens, but it is not as timely or specific as measuring plasma tryptase levels during an acute allergic reaction. In the educational context, it is essential for pediatric nurses to understand the most reliable and timely diagnostic tests for anaphylaxis in children to ensure prompt and accurate diagnosis and treatment. Recognizing the importance of plasma tryptase in confirming anaphylaxis can help nurses provide appropriate and timely care to children experiencing severe allergic reactions.

Correct Answer: D

Rationale: Food protein-induced enterocolitis syndrome (FPIES) is a rare but serious non-IgE mediated gastrointestinal food hypersensitivity that primarily affects young infants. The correct answer, option D, is "commonly improved with ingestion of soy protein-based formula." This statement is incorrect because FPIES typically does not improve with the ingestion of soy protein-based formula. In fact, soy protein is one of the common triggers for FPIES. Option A, "manifests in the first months of life," is correct as FPIES often presents in the first few months of life when solid foods are introduced. Option B, "vomiting occurs 1-3 hours after feeding," is also correct as one of the hallmark symptoms of FPIES is repetitive vomiting within a few hours after ingestion of the trigger food. Option C, "hypotension occurs in approximately 15% of cases," is also correct as FPIES can lead to severe dehydration and low blood pressure in some cases. Educational Context: Understanding the clinical presentation and management of FPIES is crucial for pediatric nurses, as timely recognition and appropriate intervention are essential in managing this condition. Educating caregivers about potential triggers, symptoms, and the importance of avoiding certain foods is key in preventing FPIES episodes. Nurses play a vital role in providing support and guidance to families dealing with FPIES, emphasizing the significance of early recognition and prompt management to prevent complications.

Correct Answer: D

Rationale: The correct answer is D) pulmonary fibrosis. Allopurinol is a xanthine oxidase inhibitor commonly used to treat gout by lowering uric acid levels in the blood. While allopurinol is associated with several potential adverse reactions, including exanthem (a rash) as a common allergic reaction, severe skin reactions like Stevens-Johnson syndrome and toxic epidermal necrolysis are also possible but rare. Pulmonary fibrosis, however, is not typically associated with allopurinol use. It is important for healthcare providers, especially pediatric nurses, to be aware of common side effects and allergic reactions associated with medications frequently used in pediatric populations. Understanding these potential adverse effects is crucial for timely identification, management, and prevention of serious complications in pediatric patients. Nurses play a key role in medication administration, monitoring for side effects, and educating patients and families about potential risks associated with medications.