Oligoarthritis involving 5-4 joints within the first 6 months of disease onset. The most commonly affected joint is

Correct Answer: B

Rationale: In pediatric rheumatology, oligoarthritis refers to arthritis that affects a few joints. In this case, involving 5-4 joints within the first 6 months of disease onset indicates a pattern consistent with juvenile idiopathic arthritis (JIA). The most commonly affected joint in oligoarthritis JIA is the knee, making option B the correct answer. The knee is a common site of involvement in oligoarthritis JIA due to its vulnerability to inflammation in children. The synovial lining of the knee joint is a frequent target of the autoimmune response seen in JIA, leading to pain, swelling, and stiffness in this joint. Options A, C, and D are incorrect in this context. The hip (option A) is less commonly affected in oligoarthritis JIA. The elbow (option C) and wrist (option D) can be involved in JIA, but they are not typically the most commonly affected joints in oligoarthritis presentations. Understanding the typical joint involvement patterns in different types of pediatric arthritis is crucial for nurses caring for pediatric patients with rheumatologic conditions. Recognizing the most commonly affected joints can aid in early detection, appropriate management, and improved outcomes for these children.

Correct Answer: B

Rationale: In this question, the correct answer is B) Chlamydia trachomatis. Chlamydia trachomatis is an intracellular bacterium known to cause chronic arthritis following genitourinary tract infection. This bacterium has been associated with reactive arthritis, also known as Reiter's syndrome, which can manifest as chronic arthritis after an initial infection. The other options are not likely to cause chronic arthritis after bacterial enteric or genitourinary tract infections. A) Escherichia coli is a common cause of UTIs and enteric infections, but it is not typically associated with chronic arthritis. C) Proteus mirabilis is a bacterium that can cause UTIs but is not commonly linked to chronic arthritis. D) Pseudomonas aeruginosa is more commonly associated with opportunistic infections in immunocompromised individuals rather than chronic arthritis following enteric or genitourinary infections. Understanding the specific microorganisms associated with certain clinical manifestations is crucial for pediatric nurses to provide accurate care and treatment to patients. Recognizing the connection between Chlamydia trachomatis and reactive arthritis can help nurses in early diagnosis and appropriate management of such cases.

Correct Answer: C

Rationale: The correct answer is C) cardiac arrhythmias. In Juvenile dermatomyositis (JDM), cardiac involvement is rare compared to other complications. While JDM primarily affects the skin and muscles, leading to weakness and muscle atrophy, it can also involve other organs like the gastrointestinal tract, leading to issues such as aspiration and gastrointestinal bleeding. Educational Context: Understanding the common complications of JDM is crucial for pediatric nurses to provide comprehensive care to children with this condition. Recognizing the least common complication, such as cardiac arrhythmias, helps nurses prioritize care and monitor patients effectively. By knowing the typical complications, nurses can anticipate potential issues, intervene promptly, and collaborate with the healthcare team to optimize outcomes for children with JDM.

Correct Answer: C

Rationale: Colchicine is an anti-inflammatory medication that is known to be effective in preventing the development of AA amyloidosis, a condition characterized by the deposition of amyloid protein in organs. In this case, the correct answer is C) familial Mediterranean fever (FMF). FMF is an autosomal recessive disease characterized by recurrent episodes of fever, serositis, and arthritis. One of the complications of FMF is the development of AA amyloidosis due to chronic inflammation. Colchicine is the mainstay treatment for FMF and has been shown to reduce the frequency of acute attacks and the risk of developing AA amyloidosis. Option A) juvenile idiopathic arthritis is incorrect because colchicine is not typically used in the treatment of this condition. Juvenile idiopathic arthritis is usually managed with nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs) depending on the subtype. Option B) ankylosing spondylitis is also incorrect as colchicine is not a standard treatment for this condition. Ankylosing spondylitis is managed with NSAIDs, physical therapy, and in some cases, biologic agents like TNF-alpha inhibitors. Option D) hyper IgD syndrome is incorrect because colchicine is not indicated for this genetic autoinflammatory disorder. Hyper IgD syndrome is managed symptomatically, and colchicine is not a primary treatment for this condition. Educationally, understanding the use of colchicine in preventing AA amyloidosis in FMF highlights the importance of appropriate medication choices based on the underlying pathophysiology of a disease. It also emphasizes the significance of recognizing the role of inflammation in certain diseases and how targeted therapies like colchicine can help prevent serious complications like amyloidosis.

Correct Answer: B

Rationale: In the context of caring for foster care children as a pediatrician, the most common significant problem is abuse and neglect (Option B). This is because children in foster care often come from backgrounds where they have experienced trauma, abuse, or neglect, which can have profound impacts on their physical, emotional, and mental well-being. Abuse and neglect are pervasive issues in the lives of many foster care children, leading to a range of health problems, developmental delays, behavioral issues, and emotional challenges. As a pediatrician, it is crucial to be aware of and vigilant for signs of abuse and neglect in these vulnerable children to ensure their safety and well-being. Regarding the other options: - Chronic medical problems (Option A) may be prevalent in some foster care children, but they are not as universally common or pervasive as the effects of abuse and neglect. - Mental health concerns (Option C) are indeed significant in this population, but often stem from the trauma of abuse and neglect. - Family relationship problems (Option D) can be a consequence of abuse and neglect but are not as consistently the primary issue as the abuse and neglect itself. Educationally, understanding the prevalence and impact of abuse and neglect on foster care children is crucial for healthcare providers working with this population. By recognizing the primary challenges these children face, healthcare professionals can better advocate for their needs, provide appropriate interventions, and work towards improving their overall health and well-being.