Regarding bronchial asthma, all of the following are true except:

Correct Answer: C

Rationale: In pediatric nursing, understanding bronchial asthma is crucial for providing effective care to children with this condition. In this question, option C is incorrect because chest examination in bronchial asthma may not always reveal bilateral wheezes. Option A is correct because bronchial asthma typically presents with episodic symptoms of airflow obstruction, such as wheezing, coughing, and shortness of breath. Option B is correct as well since the symptoms of bronchial asthma can be reversed with the use of β2 agonists like albuterol, which help dilate the airways and improve airflow. Option D is correct because inhaled corticosteroids are indeed considered a cornerstone in long-term therapy for bronchial asthma. These medications help reduce airway inflammation, which is a key component in managing asthma symptoms and preventing exacerbations. Educationally, it is important for pediatric nurses to be well-versed in the clinical presentation, management, and treatment of bronchial asthma in children. Recognizing the characteristic symptoms, understanding the role of different medications, and being able to differentiate between normal and abnormal findings on examination are essential skills when caring for pediatric patients with asthma. This knowledge allows nurses to provide optimal care, educate families on asthma management strategies, and intervene promptly in case of exacerbations.

Correct Answer: D

Rationale: In Basic Life Support (BLS), it is crucial to immobilize the cervical spine if there is a possibility of a spinal cord injury. This is important to prevent further damage to the spine and spinal cord, which could lead to long-term complications or even paralysis. Immobilizing the cervical spine involves maintaining the head and neck in a neutral position to limit movement and minimize the risk of exacerbating any potential injuries. Option A, to get the 'sniffing' position, is incorrect in this context because it refers to positioning the head and neck to facilitate airway management during intubation, not cervical spine immobilization. Option B, to fix an oral airway, is also incorrect as it pertains to maintaining a clear airway by using adjuncts like oral airways but does not address cervical spine immobilization. Option C, to clear the oropharynx, is incorrect because it focuses on airway clearance to ensure adequate breathing but does not pertain to cervical spine immobilization. In an educational context, understanding the importance of cervical spine immobilization in BLS is crucial for healthcare providers, especially pediatric nurses. Properly immobilizing the cervical spine can prevent secondary injuries and is a fundamental aspect of providing safe and effective care in emergency situations. Nurses must be knowledgeable about when and how to immobilize the cervical spine to ensure the best outcomes for their pediatric patients in need of resuscitation or critical care.

Correct Answer: A

Rationale: In this question, the correct answer is A) The mechanism of action is not known. Corticosteroids are commonly used in the treatment of allergies, asthma, and various inflammatory conditions. The mechanism of action of corticosteroids is well understood - they work by inhibiting the production of inflammatory mediators by suppressing the immune response. Option B) Corticosteroids are lymphopenic is incorrect because corticosteroids actually cause lymphocytosis, an increase in the number of lymphocytes in the blood. Option C) Corticosteroids decrease synthesis of prostaglandins is incorrect because corticosteroids mainly inhibit the synthesis of leukotrienes, not prostaglandins. Option D) Long-term usage suppresses linear growth in children is incorrect because while long-term corticosteroid use in children can lead to various side effects, such as adrenal suppression or decreased bone density, it does not directly suppress linear growth. Educationally, understanding the mechanism of action and common side effects of corticosteroids is crucial for healthcare professionals, especially pediatric nurses, who may be administering these medications to children. It is important to be aware of the potential effects of corticosteroids on growth and development in children to provide safe and effective care.

Correct Answer: D

Rationale: The correct answer is D) Anaphylactic shock. Anaphylactic shock is a severe, life-threatening allergic reaction that can occur rapidly after exposure to an allergen, such as a vaccine component. In this scenario, the sudden onset of symptoms like flushing, tachycardia, tachypnea, weak peripheral pulses, and altered consciousness are classic signs of anaphylactic shock. Option A) Cardiogenic shock is unlikely in this case because the symptoms described are more indicative of a systemic allergic reaction rather than a primary cardiac issue. Option B) Distributive shock, often seen in conditions like sepsis or anaphylaxis, involves widespread vasodilation and hypoperfusion but does not fully explain the specific symptoms presented in the case. Option C) Hypovolemic shock results from a significant loss of blood or fluid volume, which is not a primary cause of the symptoms observed post-vaccination in this scenario. In an educational context, it is crucial for pediatric nurses to be able to recognize and respond promptly to allergic reactions, including anaphylactic shock, especially in the context of vaccine administration. Understanding the signs and symptoms of anaphylaxis, along with appropriate interventions such as administering epinephrine, can be life-saving in such situations. Nurses should also be trained to differentiate between different types of shock to provide optimal care for pediatric patients.

Correct Answer: D

Rationale: In pediatric basic life support (BLS), it is crucial to follow guidelines tailored to children to ensure the best possible outcomes in an emergency situation. The correct answer, option D, states that the encircling technique is used to perform chest compressions on a child during BLS. This technique involves encircling the child's chest with both hands to provide effective and appropriate compressions to the sternum, reflecting the importance of proper hand placement and technique in pediatric BLS. Option A, stating that the priority is to intubate the child, is incorrect. In pediatric BLS, the immediate focus should be on providing high-quality chest compressions to maintain circulation before considering advanced airway interventions like intubation. Option B, mentioning that chest compressions are indicated if heart sounds are weak, is also incorrect. In pediatric BLS, chest compressions are initiated based on the absence of a pulse or effective circulation, not solely on the strength of heart sounds. Option C, suggesting a compression to ventilation ratio of 15:2, is outdated. Current guidelines recommend a compression to ventilation ratio of 30:2 for single rescuer CPR in children, emphasizing the importance of providing adequate chest compressions to maintain perfusion. Educationally, understanding the specific techniques and guidelines for pediatric BLS is essential for healthcare providers working with children. Proper training and adherence to current protocols can significantly impact the outcomes of pediatric cardiac arrest situations, making this knowledge critical for pediatric nurses and other healthcare professionals caring for children.