Regarding bronchial asthma:

Correct Answer: C

Rationale: In the context of pediatric cardiovascular nursing and pharmacology, understanding bronchial asthma is crucial for providing effective care to pediatric patients. The correct answer, option C, "Nocturnal cough is a recognized feature," is supported by the characteristic nocturnal worsening of asthma symptoms due to circadian variations in airway function and inflammation. This symptom is important for nurses to recognize as it can indicate poor asthma control and the need for adjustments in the patient's treatment plan, such as optimizing medication dosages or adding new medications. Option A, "Mortality has shown an increase during the past three decades," is incorrect as advancements in asthma management and education have actually contributed to a decrease in asthma-related mortality rates over the years. Nurses should be aware of this trend to provide accurate information and reassurance to patients and their families. Option B, "The incidence is greater in males than females," is incorrect as asthma prevalence is higher in females across all age groups, including pediatric patients. Nurses should be knowledgeable about this epidemiological data to provide gender-specific education and support to patients and families. Option D, "Post-RSV bronchial hyperreactivity is strongly associated with atopy," is incorrect as post-respiratory syncytial virus (RSV) bronchial hyperreactivity is more commonly linked to recurrent wheezing rather than atopy. Nurses should understand this distinction to differentiate between different underlying causes of respiratory symptoms in pediatric patients. In an educational context, understanding these nuances in asthma presentation and associations is essential for pediatric cardiovascular nurses to deliver comprehensive care, educate patients and families, and collaborate effectively with the healthcare team to optimize patient outcomes. By mastering these concepts, nurses can enhance their clinical judgment and decision-making skills in managing pediatric patients with bronchial asthma.

Correct Answer: B

Rationale: In common variable immunodeficiency (CVID), the correct answer is B) There is increased incidence of autoimmune disorders in families of affected members. This is because CVID is characterized by impaired B cell function, leading to decreased production of antibodies. This deficiency in antibody production can result in an increased susceptibility to infections and autoimmune disorders. Option A) B cells are totally absent is incorrect because in CVID, B cells are present but they do not function properly, leading to a reduction in antibody production. Option C) IgA levels are characteristically normal is incorrect because CVID is characterized by low levels of multiple classes of immunoglobulins, including IgA. Option D) T lymphocytes are usually affected is incorrect because CVID primarily affects B cell function and antibody production, rather than T lymphocytes. In an educational context, understanding the manifestations of CVID is important for nurses caring for pediatric patients with this condition. Recognizing the association with autoimmune disorders can guide healthcare providers in anticipating and managing potential complications in these patients. It is crucial for nurses to have a solid foundation in pediatric pharmacology to provide safe and effective care for children with complex conditions such as CVID.

Correct Answer: C

Rationale: In a 6-week-old infant, the features mentioned in option C (biopsy specimen showing proliferation of bile ductules, periportal fibrosis, and bile lakes) are more suggestive of biliary atresia rather than neonatal hepatitis. Biliary atresia is a serious condition where there is a blockage or absence of bile ducts, leading to bile accumulation and liver damage. The biopsy findings in option C are characteristic of the changes seen in biliary atresia. Option A (hepatomegaly) and option B (prolonged INR) can be seen in both biliary atresia and neonatal hepatitis, making them less specific for differentiating between the two conditions. Option D (HIDA scan revealing delayed uptake and excretion of contrast material) is also more indicative of biliary atresia due to the impaired bile flow characteristic of this condition. Understanding the distinguishing features between biliary atresia and neonatal hepatitis is crucial for pediatric nurses to provide prompt and appropriate care. Recognizing the diagnostic criteria and clinical presentation of these conditions can lead to timely interventions such as surgical correction in biliary atresia cases, improving outcomes for these vulnerable patients.

Correct Answer: A

Rationale: Peak expiratory flow rate (PEFR) is a valuable parameter in assessing improvement in acute bronchial asthma because it measures the maximum rate at which a person can exhale air. Option A is correct because changes in PEFR can indicate the effectiveness of therapy in managing acute asthma exacerbations. By regularly monitoring PEFR, healthcare providers can assess the severity of airflow limitation and response to treatment. Option B is incorrect because PEFR primarily reflects large airway resistance rather than small airway resistance. Small airway resistance is better assessed by other pulmonary function tests such as forced expiratory volume in 1 second (FEV1). Option C is incorrect because PEFR is actually more related to age and gender rather than height. Age and gender can influence lung development and function, impacting PEFR values. Option D is incorrect because using PEFR to guide aminophylline therapy in acute asthma is not evidence-based practice. A PEFR less than 50% of normal may indicate severe airflow limitation, but treatment decisions should be based on clinical guidelines and individual patient factors. In an educational context, understanding the significance of PEFR in pediatric cardiovascular nursing is crucial for providing comprehensive care to children with respiratory conditions like asthma. By grasping the role of PEFR in monitoring asthma severity and treatment response, nurses can effectively collaborate with the healthcare team to optimize patient outcomes.

Correct Answer: B

Rationale: In pediatric patients with renal osteodystrophy, the correct contributing feature is hyperparathyroidism (option B). Hyperparathyroidism occurs as a result of chronic kidney disease, leading to secondary hyperparathyroidism, which contributes to the development of renal osteodystrophy. Option A, hypophosphatemia, is not typically associated with renal osteodystrophy. Instead, renal osteodystrophy is characterized by abnormalities in calcium, phosphate, and parathyroid hormone levels. Option C, increased loss of calcium in the kidney, may seem plausible, but the primary issue in renal osteodystrophy is not increased loss but rather disturbances in the balance of calcium, phosphate, and parathyroid hormone metabolism. Option D, hypoalbuminemia, is not directly linked to renal osteodystrophy. While hypoalbuminemia can occur in renal disease, it is not a primary contributing factor to the development of renal osteodystrophy. Educationally, understanding the pathophysiology of renal osteodystrophy in pediatric patients is crucial for nurses caring for these individuals. By grasping the specific factors involved, nurses can better assess, manage, and educate patients and families about the condition and its implications. This knowledge aids in providing holistic care and promoting positive outcomes for pediatric patients with renal osteodystrophy.