Skin biopsy for diagnosis of possible urticarial vasculitis is recommended for

Correct Answer: A

Rationale: The correct answer is A) urticarial lesions that persist at different locations for >24 hr. Skin biopsy for diagnosis of possible urticarial vasculitis is recommended in cases where the urticarial lesions persist for longer than 24 hours at different locations. This is because urticarial vasculitis presents with urticarial lesions that are typically more persistent and last longer than typical hives. Option B) those with non-pigmented or non-purpuric components is incorrect because the absence of pigmented or purpuric components does not specifically indicate the need for a skin biopsy in the context of urticarial vasculitis. Option C) those that burn more than itch is incorrect as the sensation of burning over itching is not a specific indication for a skin biopsy in cases of suspected urticarial vasculitis. Option D) those with associated collagen vascular diseases is incorrect because the presence of collagen vascular diseases is not the sole criteria for recommending a skin biopsy in suspected cases of urticarial vasculitis. Educationally, understanding the specific criteria for when to recommend a skin biopsy for urticarial vasculitis is crucial for healthcare providers, especially in pediatric nursing. This knowledge helps in accurate diagnosis, appropriate treatment planning, and better patient outcomes. Recognizing the characteristics of urticarial vasculitis and its diagnostic approach is essential for providing comprehensive care to pediatric patients with skin conditions.

Correct Answer: B

Rationale: The correct answer is B) 25%. In pediatric nursing, understanding the prevalence of severe anaphylactic reactions in children with food allergies is crucial for providing safe and effective care. Research indicates that approximately 25% of children with food allergies may experience severe anaphylactic reactions, which can be life-threatening. This statistic underscores the importance of early recognition of symptoms, prompt intervention, and patient education to prevent and manage such reactions. Option A) 15% is incorrect because it underestimates the prevalence of severe anaphylactic reactions in children with food allergies. Choosing this option could lead to a misunderstanding of the potential severity of allergic reactions in pediatric patients. Option C) 35% and Option D) 45% are both incorrect as they overestimate the percentage of children with food allergies experiencing severe anaphylactic reactions. Selecting these options may lead to unnecessary fear and anxiety among healthcare providers and caregivers, as well as potentially inappropriate management strategies for allergic reactions in children. In an educational context, this question serves to reinforce the importance of evidence-based practice in pediatric nursing. By understanding the prevalence of severe anaphylactic reactions in children with food allergies, nurses can tailor their care plans to effectively prevent, recognize, and manage such reactions, ultimately improving patient outcomes and safety.

Correct Answer: C

Rationale: In the context of pediatric nursing, understanding the causes of vasculitis is crucial for providing comprehensive care to pediatric patients. In this question, the correct answer is C) penicillamine. Penicillamine is a medication used in the treatment of Wilson's disease and rheumatoid arthritis, and it is known to be associated with drug-induced vasculitis. Option A) isoniazid is primarily used in the treatment of tuberculosis and is not a common cause of vasculitis. Option B) sulfonamide antibiotics are known to be associated with drug-induced lupus but not vasculitis. Option D) calcium channel blockers are used to treat conditions like hypertension and angina, but they are not typically associated with causing vasculitis. Educationally, this question highlights the importance of medication awareness in pediatric nursing practice. Nurses need to be knowledgeable about potential adverse effects of medications to monitor for and manage complications effectively. Understanding the relationship between certain medications and vasculitis can help nurses assess and intervene promptly to ensure positive patient outcomes.

Correct Answer: D

Rationale: In vivo skin testing for allergen-specific IgE is a common diagnostic tool in pediatric nursing to identify allergens causing allergic reactions. The correct answer, option D, "not suppressed by antihistamines," is right because in vivo skin testing is not affected by the use of antihistamines, unlike in vitro tests like ImmunoCAP, which can be impacted by antihistamines and certain other medications. Option A, "less expensive," is incorrect because in vivo skin testing can be costly due to the need for specialized training and materials. Option B, "greater sensitivity," is incorrect because in vitro tests like ImmunoCAP generally have higher sensitivity compared to in vivo skin testing. Option C, "wide allergen selection," is incorrect as in vivo skin testing typically has a more limited allergen panel compared to in vitro tests. Educationally, understanding the nuances of different allergy testing methods is crucial for pediatric nurses to accurately diagnose and manage allergic conditions in children. Knowing the advantages and limitations of in vivo skin testing versus in vitro tests helps nurses make informed decisions on the most appropriate diagnostic approach for each patient.

Correct Answer: B

Rationale: In pediatric nursing, understanding risk factors for persistent asthma is crucial for providing effective care to children. The correct answer, option B) allergic conjunctivitis, is not typically a risk factor for persistent asthma. Asthma and allergic conjunctivitis can coexist, but the presence of allergic conjunctivitis alone does not necessarily increase the risk of persistent asthma. Option A) atopic dermatitis is a known risk factor for persistent asthma. Children with atopic dermatitis are more likely to develop asthma due to the shared underlying allergic mechanisms. Option C) elevated total serum IgE levels in the first year of life is also a risk factor for persistent asthma. Elevated IgE levels are associated with allergic sensitization, which can contribute to asthma development. Option D) peripheral blood eosinophilia >4% in children aged 2-3 years is another risk factor for persistent asthma. Eosinophils are a type of white blood cell involved in allergic responses, and their elevation can indicate ongoing allergic inflammation, which is common in asthma. Educationally, understanding these risk factors helps nurses in early identification, prevention, and management of pediatric asthma. By recognizing these factors, healthcare providers can implement appropriate interventions to reduce asthma exacerbations and improve the quality of life for children with asthma.