Postinfectious arthritis describes arthritis that occurs after infectious illnesses, mainly viruses. Of the following, rubella the LEAST likely causative viral infection is

Correct Answer: C

Rationale: The correct answer is C) Epstein-Barr virus. Postinfectious arthritis is a condition where joint inflammation occurs after an infectious illness, often caused by viruses. Rubella, also known as German measles, is associated with arthritis, making it a likely causative viral infection. Varicella-zoster (causes chickenpox and shingles), cytomegalovirus (can cause arthritis in immunocompromised individuals), and herpes simplex virus (can lead to arthritis in some cases) are all known to be associated with arthritis as well, but the question asked for the LEAST likely causative viral infection. Educationally, understanding the associations between viral infections and arthritis is crucial for pediatric nurses. This knowledge helps in identifying potential causes of joint inflammation in children, allowing for timely interventions and appropriate management. By differentiating between the various viral infections and their likelihood of causing postinfectious arthritis, nurses can provide more effective care to pediatric patients with these conditions.

Correct Answer: A

Rationale: In patients with familial Mediterranean fever (FMF), secondary amyloidosis can develop due to chronic inflammation. The organ most seriously affected by secondary amyloidosis in FMF is the kidney. This is because amyloid deposits in the kidney can lead to renal failure, which is a serious complication of the disease. Option A, kidney, is the correct answer because renal involvement is a hallmark feature of secondary amyloidosis in FMF. The deposition of amyloid in the kidney can impair its function and ultimately lead to renal failure if left untreated. Options B, lung, C, nerve, and D, heart, are incorrect because while secondary amyloidosis can affect multiple organs, the kidney is most commonly and severely affected in FMF. Lung involvement is rare in FMF-related amyloidosis, nerve involvement typically manifests as peripheral neuropathy rather than systemic amyloidosis, and heart involvement is less common compared to renal involvement in FMF-related secondary amyloidosis. In an educational context, understanding the specific organ involvement in secondary amyloidosis associated with FMF is crucial for nurses caring for pediatric patients with this condition. Recognizing the signs and symptoms of renal impairment can help in early detection and intervention to prevent complications such as renal failure. This knowledge is essential for providing comprehensive care and improving outcomes for pediatric patients with FMF.

Correct Answer: D

Rationale: The correct answer is D) Takayasu arteritis, as it predominantly affects large blood vessels. Takayasu arteritis is a rare autoimmune disease that causes inflammation in the walls of the aorta and its main branches. This results in narrowing or blockage of these arteries, leading to reduced blood flow to various organs. Option A) Henoch-Schonlein purpura primarily involves small blood vessels and is characterized by a rash, joint pain, gastrointestinal symptoms, and kidney inflammation. Option B) Polyarteritis nodosa affects medium-sized arteries, leading to organ damage due to poor blood supply. It typically does not involve large blood vessels as in the case of Takayasu arteritis. Option C) Kawasaki disease mainly affects medium-sized arteries, particularly the coronary arteries in children. It is characterized by fever, rash, swollen lymph nodes, red eyes, lips, and tongue, and can lead to coronary artery aneurysms if not treated promptly. Educationally, understanding the differences in the types of vasculitis based on the size of blood vessels affected is crucial for pediatric nurses. Recognizing the specific characteristics and target organs of each disease aids in accurate diagnosis, appropriate treatment, and prevention of complications. Nurses play a key role in early identification, monitoring, and management of vasculitis in children to promote optimal outcomes and quality of life.

Correct Answer: D

Rationale: In cases of retinal hemorrhage caused by abusive head trauma (AHT), one of the key distinguishing features is the presence of traumatic retinoschisis. This condition is not typically associated with AHT-related retinal hemorrhages, making option D the correct answer. Multiple retinal hemorrhages are a common finding in AHT cases, which aligns with option A. These hemorrhages often involve multiple layers of the retina (option B) and are frequently located centrally (option C). However, traumatic retinoschisis, which involves a splitting of the retinal layers, is not a typical feature of AHT-related retinal hemorrhages. Educationally, understanding the specific characteristics of retinal hemorrhages in cases of AHT is crucial for pediatric nurses as they play a vital role in identifying and reporting suspected cases of child abuse. Recognizing these distinctive features can aid in early detection and intervention, ultimately safeguarding the well-being of vulnerable pediatric patients.

Correct Answer: B

Rationale: In pediatric nursing, failure to thrive is a critical issue that requires close monitoring and intervention. The correct answer, option B (20-30 gm/kg/day), is the minimal accepted catch-up weight gain for a 10-month-old child with failure to thrive. This rate of weight gain is considered appropriate for achieving catch-up growth without overloading the child's system. Option A (10 gm/kg/day) is too low for a child with failure to thrive to adequately catch up in weight gain. This rate may not provide sufficient nutritional support for the child's growth needs. Option C (40-50 gm/kg/day) and option D (60 gm/kg/day) are too high and could potentially lead to overfeeding, which may overwhelm the child's digestive system and cause other complications. Educationally, understanding the appropriate rate of weight gain in children with failure to thrive is crucial for pediatric nurses. It helps them tailor feeding plans to meet the specific needs of each child, promoting optimal growth and development. Monitoring weight gain closely and adjusting feeding strategies accordingly is essential in managing failure to thrive in pediatric patients.