Oligoarthritis predominantly affects the joints of the lower extremities rather than upper extremity joints. Which of the following joints is never a presenting sign of oligoarthritis?

Correct Answer: D

Rationale: In pediatric nursing, understanding the presentation of oligoarthritis is crucial for accurate assessment and intervention. The correct answer, option D (interphalangeal joints), is never a presenting sign of oligoarthritis. This is because oligoarthritis primarily affects larger joints, such as the knee, ankle, or hip. The interphalangeal joints are smaller joints in the fingers and toes, and their involvement is more commonly seen in conditions like juvenile idiopathic arthritis. Option A (hip), option B (knee), and option C (ankle) are all incorrect choices for this question because these joints are commonly affected in oligoarthritis. Understanding this distinction is essential for nurses caring for pediatric patients with joint-related conditions. By recognizing the typical joint manifestations of oligoarthritis, healthcare providers can make timely assessments, implement appropriate treatment plans, and provide holistic care to improve outcomes for pediatric patients. Educationally, this question helps reinforce the importance of recognizing patterns of joint involvement in pediatric rheumatologic conditions. It highlights the need for nurses to have a strong foundation in differentiating between joint presentations to provide effective care and support to pediatric patients with arthritis. This knowledge can guide clinical decision-making and promote positive health outcomes for children with oligoarthritis.

Correct Answer: C

Rationale: In pediatric nursing, understanding systemic lupus erythematosus (SLE) in children is crucial due to its impact on their health. The correct answer, option C, "it usually presents before 5 years of age," is correct because childhood SLE typically presents in late childhood or adolescence, unlike adult-onset SLE. Option A, "it has a more severe course," is incorrect because childhood SLE generally has a milder course compared to adult SLE. Option B, "there is more widespread organ involvement," is incorrect as childhood SLE tends to involve fewer organs than adult SLE. Option D, "fever, fatigue, hematologic abnormalities, and arthritis are common clinical manifestations," is incorrect as these are common manifestations in both childhood and adult SLE. Educationally, knowing the differences in SLE presentation in children versus adults is vital for accurate diagnosis and management. Understanding these distinctions can help pediatric nurses provide appropriate care, support families, and advocate for children with SLE effectively. This knowledge enhances the quality of care provided to pediatric patients with autoimmune conditions like SLE.

Correct Answer: D

Rationale: Juvenile localized scleroderma (LS) is a rare autoimmune disorder that primarily affects the skin, but in some cases, it can involve deeper tissues and organs. The subtype MOST commonly associated with neurological manifestations is en coup de sabre. This subtype presents with a linear sclerotic lesion on the frontoparietal scalp that can extend to the forehead and nose, often resembling a sword wound. Neurological symptoms such as seizures, headaches, and focal neurological deficits can occur due to involvement of the underlying brain tissue. Option A, plaque morphea, typically presents with thickened oval-shaped plaques on the skin without significant systemic involvement, making it less likely to be associated with neurological symptoms. Option B, eosinophilic fasciitis, is characterized by inflammation of the fascia rather than the skin and is not commonly linked to neurological manifestations. Option C, generalized morphea, involves widespread areas of skin hardening but is less commonly associated with neurological complications compared to en coup de sabre. Educationally, understanding the different subtypes of juvenile LS and their associated manifestations is crucial for pediatric nurses to provide comprehensive care to affected children. Recognizing the unique features of each subtype can aid in early identification of potential complications, such as neurological involvement in en coup de sabre, leading to prompt treatment and improved outcomes for patients.

Correct Answer: A

Rationale: In the context of Kawasaki disease (KD), predicting poor outcomes is crucial for timely intervention and management. In this case, option A (old age) is the correct answer as it is not a predictor of poor outcome in KD. Older age is not typically associated with worse outcomes in KD, unlike in other conditions where age can be a significant factor. Male gender (option B) is a known risk factor for coronary artery abnormalities in KD. Persistent fever (option C) is a key clinical feature of KD and can indicate ongoing inflammation and risk of complications. Poor response to IVIG (option D) is a concerning sign as IVIG is a primary treatment for KD; failure to respond may indicate more severe disease and higher risk of poor outcomes. In an educational setting, understanding predictors of poor outcomes in KD is essential for nurses caring for pediatric patients. By recognizing these factors, nurses can monitor patients closely, advocate for timely interventions, and communicate effectively with the healthcare team to ensure the best possible outcomes for children with KD.

Correct Answer: D

Rationale: The correct answer is D) cyberbullying. Witnessing violence, whether in the community or through media, can have significant negative effects on children's mental and emotional well-being. When children are exposed to violence, they are at risk of experiencing poor school performance, symptoms of anxiety and depression, and lower self-esteem. These adverse effects stem from the trauma and distress caused by witnessing violence, which can impact a child's ability to focus on academics, lead to emotional disturbances, and erode their sense of self-worth. Cyberbullying, while also a serious issue affecting children today, is not directly related to the increased impact of violence on children. Cyberbullying typically occurs in the digital realm and is more closely linked to interpersonal conflicts, online behavior, and social dynamics among peers. While exposure to violence can certainly exacerbate existing vulnerabilities and contribute to a child's susceptibility to cyberbullying, it is not a direct consequence of the increased impact of violence. In an educational context, it is important for healthcare providers, educators, and caregivers to be aware of the detrimental effects of violence on children's well-being. By understanding how exposure to violence can manifest in various forms of distress and impairment, professionals can intervene early to provide appropriate support and resources for affected children. Recognizing the signs and symptoms of trauma and addressing the underlying causes are crucial steps in promoting the mental health and resilience of children in the face of violence.