Rheumatoid factor (RF) positivity in individuals with extra-articular manifestations is almost exclusively occur in RF-positive polyarthritis characterized by aggressive manifestation that is almost exclusively occurs in symmetrical arthritis of both upper and lower extremities. Which of the following is NOT correlated with ANA positivity?

Correct Answer: D

Rationale: In this question, the correct answer is D) younger female. The presence of rheumatoid factor (RF) positivity in individuals with extra-articular manifestations is typically associated with a more aggressive form of rheumatoid arthritis. In the context of this question, the other factors listed - uveitis, sex, and age of onset - are all correlated with ANA positivity. - A) Uveitis: Uveitis is an inflammatory condition of the eye that can be associated with autoimmune diseases like rheumatoid arthritis, where ANA positivity can be present. - B) Sex: Females are more commonly affected by autoimmune diseases like rheumatoid arthritis, where ANA positivity is a common finding. - C) Age onset at disease: The age at which rheumatoid arthritis manifests can influence the disease course and severity, with ANA positivity often being detected in younger individuals. Educationally, understanding the correlation between certain clinical features and laboratory findings like ANA positivity is crucial in diagnosing and managing autoimmune conditions, particularly in pediatric patients. This knowledge helps healthcare providers form a comprehensive picture of the patient's condition and tailor treatment plans accordingly. It also highlights the importance of considering various factors when assessing and managing pediatric patients with autoimmune disorders.

Correct Answer: A

Rationale: In systemic lupus erythematosus (SLE), periods of smoldering disease or quiescence are common, alternating with flare-ups of active disease. When the disease is active, certain lab tests reflect this increased disease activity. Option A, the anti-nuclear antibody (ANA) titer, is not specific to active disease in SLE. ANA can be positive even during periods of quiescence. However, options B, C, and D are indicative of active disease in SLE. Option B, anti-double-stranded DNA level, is specific to SLE and is often elevated during disease flares. Option C, low complement levels, and option D, high ESR, are also markers of inflammation and are elevated during active disease states in SLE. Understanding these lab tests and their significance in SLE is crucial for nurses caring for pediatric patients with this condition. Recognizing the patterns of these lab results can help healthcare providers monitor disease activity, adjust treatment plans, and improve outcomes for pediatric patients with SLE.

Correct Answer: C

Rationale: In the case of Behcet disease, which is a primary vasculitis known for oral ulceration, the characteristic features of oral ulcers play a significant role in diagnosis and management. In this question, the correct answer is C) scarring. This is because scarring is not a typical feature of oral ulcers in Behcet disease. A) Painful oral ulcers are a common feature of Behcet disease and can cause significant discomfort to the patient. B) Very recurrent oral ulcers are also typical in Behcet disease, with patients experiencing frequent episodes of ulceration. D) Location cavity heal with 3-10 days last oral ulcers is a characteristic feature of oral ulcers in Behcet disease, where ulcers typically heal within this time frame. Educationally, understanding the specific features of oral ulcers in Behcet disease is crucial for healthcare professionals, especially in pediatric nursing. Recognizing these characteristics can aid in early identification, appropriate treatment, and improved quality of care for pediatric patients with Behcet disease. It underscores the importance of thorough assessment and knowledge of disease-specific manifestations in pediatric nursing practice.

Correct Answer: A

Rationale: In the case of a child with a small solitary coronary artery aneurysm, the most appropriate therapy is option A) aspirin for 6 months. This is the correct choice because aspirin is commonly used in treating coronary artery aneurysms to prevent blood clots from forming within the aneurysm. Option B) life-long aspirin may not be necessary for a small solitary coronary artery aneurysm, as the duration of therapy should be guided by the size and stability of the aneurysm. Option C) IVIG and aspirin for 14 days is more commonly used in Kawasaki disease, which presents with coronary artery aneurysms but is not the first-line therapy for a small solitary aneurysm. Option D) aspirin and clopidogrel antiplatelet for 8 weeks may be excessive for a small solitary coronary artery aneurysm and is not the recommended standard of care. In an educational context, it is crucial for pediatric nurses to understand the appropriate management of coronary artery aneurysms in children. This question highlights the importance of evidence-based practice and individualized treatment plans based on the specific clinical scenario. Nurses must be knowledgeable about the rationale behind different treatment options to provide safe and effective care to pediatric patients with cardiac conditions.

Correct Answer: A

Rationale: The correct answer is A) neglect. Neglect is the most reported type of child abuse in the USA for several reasons. Neglect involves failing to provide for a child's basic needs such as food, shelter, clothing, education, and medical care. It can be easier to identify and report compared to other forms of abuse as signs of neglect are often more visible. Furthermore, neglect is more common than other types of abuse due to various factors such as poverty, lack of education, substance abuse, and mental health issues in families. Physical abuse (option B) involves intentional harm or injury to a child and may leave visible marks such as bruises or broken bones. Sexual abuse (option C) involves any sexual activity with a child and can be difficult to detect as it often occurs in secrecy. Psychological maltreatment (option D) includes emotional abuse, which can have long-lasting effects on a child's mental health and well-being. In an educational context, it is crucial for pediatric nurses to be able to recognize and report all forms of child abuse, including neglect. Understanding the prevalence and characteristics of different types of abuse helps nurses advocate for the well-being of their pediatric patients and work towards preventing further harm. By being knowledgeable about the signs and reporting procedures for child abuse, pediatric nurses play a vital role in protecting vulnerable children and promoting their safety and welfare.