Nasal polyps in children younger than 10 years warrant evaluation for

Correct Answer: D

Rationale: In pediatric nursing, it is crucial to understand the significance of signs and symptoms that may indicate underlying health conditions. In this scenario, nasal polyps in children under 10 years old should prompt evaluation for primary ciliary dyskinesia (PCD), making option D the correct answer. Primary ciliary dyskinesia is a genetic disorder affecting cilia's structure and function, leading to recurrent respiratory infections, chronic otitis media, and nasal polyps. These symptoms result from impaired mucociliary clearance due to dysfunctional cilia. The other options (A) celiac disease, (B) ulcerative colitis, and (C) unilateral choanal atresia are less likely causes of nasal polyps in this age group. Celiac disease and ulcerative colitis primarily affect the gastrointestinal tract and do not typically present with nasal polyps. Unilateral choanal atresia is a congenital nasal anomaly characterized by blockage of one nasal passage, but it does not commonly cause bilateral nasal polyps. Educationally, understanding the association between nasal polyps and PCD reinforces the importance of considering rare genetic disorders in the differential diagnosis of pediatric patients. It also highlights the necessity of a comprehensive assessment to accurately diagnose and manage conditions in pediatric nursing practice.

Correct Answer: B

Rationale: In pediatric nursing practice, understanding the risk factors for drug reactions to penicillins and cephalosporins is crucial for safe medication administration. The correct answer, option B, "increasing age (>20 years)," is right because pediatrics refers to the care of infants, children, and adolescents, typically up to 18 years of age. Therefore, individuals above 20 years are not considered pediatric patients. Option A, "previous drug exposure," is a common risk factor for drug reactions as sensitization can develop after initial exposure. This is especially relevant in pediatrics where children may have had previous medication exposures. Option C, "higher dose," is a significant risk factor for drug reactions as dosing errors or inappropriate dosages can lead to adverse reactions. In pediatrics, dosing calculations must be precise due to the child's size and weight. Option D, "intermittent repeated exposure," is also a risk factor as repeated exposures can increase the likelihood of developing sensitivities or reactions to the medication, especially in pediatrics where repeated courses of antibiotics are common. Educationally, understanding these risk factors is vital for pediatric nurses to ensure safe medication practices. By recognizing factors that contribute to drug reactions, nurses can implement preventive measures, such as thorough patient assessments, accurate dosing calculations, and monitoring for adverse effects. This knowledge enhances patient safety and quality of care in pediatric nursing practice.

Correct Answer: D

Rationale: The most likely diagnosis for the 7-year-old boy exhibiting separation anxiety, temper issues, and withdrawal from activities after his parents' divorce is D) Separation anxiety disorder. The correct answer, Separation anxiety disorder, is characterized by excessive anxiety concerning separation from home or from those to whom the individual is attached. In this case, the boy's symptoms align with the hallmark features of this disorder following a significant life event like his parents' divorce. Option A) Attention deficit hyperactivity disorder (ADHD) is characterized by symptoms such as inattention, hyperactivity, and impulsivity, which are different from the boy's presentation. Option B) Conduct disorder involves a pattern of violating the basic rights of others or major age-appropriate societal norms, which does not align with the symptoms described for the boy. Option C) Major depressive disorder typically includes symptoms like persistent sadness, loss of interest, changes in appetite or sleep, which are not the primary symptoms exhibited by the boy in this scenario. In an educational context, it is crucial for healthcare providers working with children to be able to differentiate between various childhood behavioral and emotional disorders based on their unique presentations. Understanding the diagnostic criteria for each disorder is essential for effective assessment, intervention, and support for children experiencing mental health challenges. Identifying and addressing separation anxiety disorder in children can help in providing appropriate interventions to support their emotional well-being during challenging life transitions.

Correct Answer: B

Rationale: In distinguishing between Crohn's disease and ulcerative colitis histologically, the presence of granulomata is a key feature that differentiates the two conditions. Granulomata are clusters of immune cells, typically macrophages, that form in response to chronic inflammation. In the context of Crohn's disease, granulomata are commonly found in the affected tissues, particularly in the submucosal layers. This feature is not typically seen in ulcerative colitis. Crypt abscesses, another option in the question, are more commonly associated with ulcerative colitis. These abscesses result from the accumulation of inflammatory cells within the crypts of the intestinal lining. Lymphocytic infiltrate, while a feature of both conditions, is not as specific a differentiator as granulomata. Paneth cells are specialized cells found in the small intestine and are not specific to either Crohn's disease or ulcerative colitis. In an educational context, understanding the histological features of inflammatory bowel diseases like Crohn's disease and ulcerative colitis is crucial for healthcare professionals, especially pediatric nurses. Recognizing these differences can aid in accurate diagnosis, appropriate treatment planning, and monitoring of disease progression in pediatric patients. By emphasizing the significance of granulomata in Crohn's disease, nurses can contribute to improved patient outcomes through early detection and targeted interventions.

Correct Answer: C

Rationale: In this question, the correct answer is C) anaphylaxis to a wasp sting. Immunotherapy is a treatment that aims to desensitize the immune system to specific allergens. In the case of anaphylaxis to a wasp sting, which is a severe and potentially life-threatening allergic reaction, immunotherapy may not provide sufficient symptomatic improvement or protection in the event of future stings. Option A, ragweed allergy, and option D, house dust mite allergy, are conditions where immunotherapy can be effective in reducing symptoms and improving quality of life by decreasing the body's allergic response to these allergens. Option B, a local reaction to a bee sting, is also a situation where immunotherapy can be beneficial in reducing the severity of future reactions to bee stings. In a pediatric nursing context, understanding the limitations and effectiveness of different treatment modalities is crucial for providing safe and evidence-based care to children with allergies. Educating patients and their families about the appropriate use of immunotherapy and its potential outcomes is essential in pediatric nursing practice.