Obsessive compulsive disorder may be associated with all of the following EXCEPT

Correct Answer: D

Rationale: Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive behaviors that individuals feel driven to perform. The correct answer, option D, "a need for sameness," is not typically associated with OCD. This is more commonly seen in conditions like autism spectrum disorder. Option A, "overconcern with body wastes," is associated with OCD due to contamination fears. Individuals with OCD may have obsessions related to germs or cleanliness, leading to excessive handwashing or avoidance behaviors. Option B, "prior group A streptococcal infection," is linked to PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), a condition where streptococcal infections trigger sudden-onset OCD symptoms in children. Option C, "excessive fears," is a hallmark of OCD. Individuals with OCD often experience irrational fears that drive their compulsive behaviors, such as fear of harm coming to themselves or loved ones. Educationally, understanding the characteristic features associated with OCD is crucial for healthcare professionals caring for pediatric patients. Recognizing these symptoms early can lead to timely intervention and support for children struggling with OCD, ultimately improving their quality of life.

Correct Answer: C

Rationale: Rationale: The correct answer is C) improves skeletal muscle paralysis. Atropine is a muscarinic antagonist that blocks the effects of acetylcholine at muscarinic receptors. While atropine can help relieve bronchospasm (Option A) by dilating the bronchioles, it can also relieve bradycardia (Option B) by blocking the vagus nerve's inhibitory effects on the heart, leading to an increase in heart rate. Atropine can also ameliorate diarrhea (Option D) by reducing gastrointestinal motility. It is crucial for healthcare providers, especially those working with pediatric patients, to understand the effects of atropine in the context of nerve agent intoxication. Nerve agents can lead to a cholinergic crisis due to excessive acetylcholine activity, causing symptoms like bronchospasm, bradycardia, and diarrhea. Administering atropine promptly can counteract these effects by blocking the overstimulation of muscarinic receptors. Understanding the specific actions of atropine is fundamental in managing nerve agent intoxication and ensuring positive patient outcomes.

Correct Answer: A

Rationale: In this question, the correct answer is A) 3 yr. The occurrence of 3 or more episodes of rhinorrhea in the first year of life is associated with allergic rhinitis (AR) at the age of 3 years. This is because recurrent rhinorrhea in infancy can be an early indicator of a predisposition to developing allergic conditions like allergic rhinitis later in childhood. Option B) 9 yr is incorrect because the onset of allergic rhinitis is typically earlier, around 3 years of age rather than waiting until 9 years old. Option C) 7 yr is also incorrect as it falls between the correct answer and the other options, but the association is strongest at 3 years. Option D) 5 yr is incorrect because the onset of allergic rhinitis is typically earlier in childhood. Educational Context: Understanding the early signs and risk factors for conditions like allergic rhinitis in pediatric patients is crucial for healthcare providers. Recognizing these signs can lead to early intervention and management, improving the quality of life for children with allergic conditions. This knowledge is essential for nurses, doctors, and other healthcare professionals working with pediatric populations to provide comprehensive care and support for children and their families.

Correct Answer: C

Rationale: The correct answer is C) 5 days. When administering skin tests in atopic hosts, it is crucial to withhold certain medications to prevent false-negative results. Montelukast, a leukotriene receptor antagonist, should be withheld for 5 days prior to skin testing. Providing an educational context, sedating antihistamines are withheld for 3-4 days because they can interfere with skin test results due to their sedative properties. Non-sedating antihistamines should be withheld for 5-7 days as they can also impact the accuracy of skin tests. Montelukast, although not an antihistamine, should be withheld for 5 days to ensure accurate skin test results. Option A) 1 day is incorrect because withholding montelukast for only 1 day may not be sufficient to prevent interference with skin test results. Option B) 3 days is incorrect as this timeframe is more appropriate for sedating antihistamines, not montelukast. Option D) 7 days is incorrect as it exceeds the recommended withholding period for montelukast, potentially delaying necessary treatment for the patient. Understanding the appropriate withholding periods for medications in skin testing is crucial for healthcare providers working with pediatric patients to ensure accurate diagnostic results and effective treatment plans.

Correct Answer: D

Rationale: The correct answer is D) 2-10 yr of age. Rationale: Spirometry is a valuable tool in assessing airflow limitation in pediatric patients. This test requires the patient to perform a full, forceful, and prolonged exhalation. While very young children may have difficulty coordinating these maneuvers effectively, as children grow older, their ability to follow instructions and perform the test accurately improves. By the age of 10, most children have developed the necessary skills to successfully complete a spirometry test. Explanation of other options: A) 2-4 yr of age: Children in this age range may not have the developmental capacity to perform spirometry accurately due to limited understanding and cooperation. B) 2-6 yr of age: While some children in this age range may be able to perform spirometry, it may not be feasible for the majority due to varying levels of cognitive and physical development. C) 2-8 yr of age: While older children in this range may be able to perform spirometry, limiting the upper age to 8 could exclude older children who are capable of completing the test effectively. Educational context: Understanding the age range in which spirometry is feasible in children is vital for healthcare professionals working with pediatric patients. It is essential to consider a child's developmental stage and ability to follow instructions when determining the appropriateness of spirometry testing. By recognizing the age range within which most children can successfully perform spirometry, healthcare providers can ensure accurate assessment of lung function and provide optimal care for pediatric patients with respiratory conditions.