Systemic lupus erythematosus (SLE) is often characterized by periods of smoldering disease or quiescence followed by flare and active disease. All the following lab tests correlate with active disease EXCEPT

Correct Answer: A

Rationale: In systemic lupus erythematosus (SLE), periods of smoldering disease or quiescence can be followed by flare-ups of active disease. When the disease is active, certain lab tests can reflect this increased disease activity. In this case, the correct answer is A) anti-nuclear antibody titer, which does not necessarily correlate with active disease in SLE. Option B) anti-double-stranded DNA level is often elevated during active disease in SLE, as antibodies to double-stranded DNA are specific to SLE. Option C) low complement levels are indicative of active disease in SLE, as complement proteins are often consumed during inflammatory processes. Option D) a high erythrocyte sedimentation rate (ESR) is a non-specific marker of inflammation and is typically elevated during active disease in SLE. From an educational perspective, understanding the significance of various lab tests in SLE is crucial for nurses caring for pediatric patients with this condition. Recognizing the patterns of these lab results can aid in early detection of disease flares and prompt intervention to prevent complications. Regular monitoring of these lab values can also help in assessing treatment effectiveness and disease progression in pediatric patients with SLE.

Correct Answer: A

Rationale: The most appropriate therapy for a child with a small solitary coronary artery aneurysm is option A) aspirin for 6 months. This is because aspirin is the standard treatment for coronary artery aneurysms in children, especially when the aneurysm is small and solitary. Aspirin helps prevent blood clots from forming in the affected artery, reducing the risk of complications such as thrombosis and embolism. Option B) life-long aspirin is not the most appropriate choice because life-long aspirin therapy may not be necessary for a small and solitary aneurysm. Prolonged aspirin use can also increase the risk of side effects like gastrointestinal bleeding. Option C) IVIG and aspirin for 14 days is not the most appropriate therapy for a solitary coronary artery aneurysm. IVIG (intravenous immunoglobulin) is typically used in Kawasaki disease to reduce inflammation and prevent coronary artery aneurysms, but in this case, where the aneurysm is small and solitary, IVIG may not be necessary. Option D) aspirin and clopidogrel antiplatelet for 8 weeks is not the most appropriate therapy for a small solitary coronary artery aneurysm. While antiplatelet therapy can be beneficial in some cases, using both aspirin and clopidogrel may be excessive and not indicated for a small, solitary aneurysm. In an educational context, understanding the appropriate treatment for coronary artery aneurysms in children is crucial for pediatric nurses. Knowing the rationale behind each treatment option helps nurses make informed decisions based on the specific clinical situation of the child. By choosing the most appropriate therapy, nurses can provide effective care and minimize potential risks or complications for their pediatric patients.

Correct Answer: A

Rationale: In the context of pediatric nursing, understanding different types of child abuse is crucial for providing comprehensive care to children. The correct answer to the question is A) neglect. Neglect is the most reported type of child abuse in the USA. Neglect occurs when a caregiver fails to provide for a child's basic needs, such as food, shelter, clothing, medical care, education, and supervision. This type of abuse can have long-lasting physical, emotional, and psychological effects on a child's development. Physical abuse (option B) involves the intentional use of force that results in physical harm or injury to a child. While physical abuse is a significant concern, it is not the most reported type of child abuse in the USA. Sexual abuse (option C) involves any sexual activity between an adult and a child. While sexual abuse is a serious issue that can have devastating consequences, neglect is more commonly reported in the USA. Psychological maltreatment (option D) includes emotional abuse and neglect, such as belittling, terrorizing, or ignoring a child's emotional needs. While psychological maltreatment is harmful to a child's well-being, neglect remains the most reported type of child abuse. Educationally, pediatric nurses must be able to recognize signs of different types of child abuse, understand reporting requirements, and provide support and resources to children and families experiencing abuse. By knowing that neglect is the most reported type of child abuse, nurses can be vigilant in assessing for signs of neglect and advocating for the safety and well-being of children in their care.

Correct Answer: A

Rationale: The correct answer is A) gastroesophageal reflux. In pediatric patients presenting with signs and symptoms of spitting, vomiting, and food refusal, gastroesophageal reflux is the most common cause. Gastroesophageal reflux occurs when the stomach contents flow back into the esophagus, leading to symptoms such as spitting, vomiting, and feeding difficulties. Option B) chronic tonsillitis is less likely to cause these specific symptoms related to feeding issues. Chronic tonsillitis typically presents with symptoms such as recurrent throat infections, difficulty swallowing, and persistent sore throat. Option C) food allergies can cause gastrointestinal symptoms, but they are more commonly associated with symptoms like diarrhea, abdominal pain, and skin rashes rather than spitting, vomiting, and food refusal. Option D) eosinophilic esophagitis is a chronic immune-mediated condition characterized by inflammation of the esophagus. It typically presents with symptoms such as difficulty swallowing, food impaction, and chest pain rather than spitting, vomiting, and food refusal. Understanding the common causes of failure to thrive in children is vital for pediatric nurses to provide accurate assessments and interventions. By recognizing the signs and symptoms associated with various conditions, nurses can work collaboratively with healthcare teams to ensure timely and appropriate management for pediatric patients experiencing feeding difficulties.

Correct Answer: A

Rationale: The correct answer is A) AquaMEPHYTON (vitamin K) at birth. Vitamin K is essential for blood clotting, and newborns are born with low levels, putting them at risk for Vitamin K deficiency bleeding (VKDB), which can lead to severe bleeding and even death. Administering AquaMEPHYTON at birth helps prevent VKDB and is a standard practice in newborn care. Option B) Home-visitor services, although important for overall infant health and well-being, would not directly prevent VKDB or the specific cause of death in this scenario. Option C) Discontinuing antibiotics is not relevant to preventing VKDB, as the issue here is related to Vitamin K deficiency. Option D) Proper use of an infant seat is crucial for preventing injuries during transportation but is not related to the prevention of VKDB. In an educational context, understanding the importance of administering Vitamin K at birth is crucial for healthcare providers working with newborns to ensure they receive appropriate care and prevent potentially life-threatening complications like VKDB. This knowledge is fundamental in pediatric nursing practice to promote the well-being of newborns and reduce preventable deaths.