Tests used in establishing a diagnosis of coeliac disease are:

Correct Answer: D

Rationale: In the context of pediatric nursing and pharmacology, it is crucial to understand the diagnostic tests for conditions like coeliac disease. In this case, the correct answer is D) Duodenal biopsy. A duodenal biopsy is considered the gold standard for diagnosing coeliac disease as it allows for the direct visualization of the small intestine lining and the detection of characteristic changes such as villous atrophy and increased intraepithelial lymphocytes. Option A) IgA anti-endomysial antibodies and Option C) IgA anti-gliadin antibodies are serologic tests that can support the diagnosis of coeliac disease but are not definitive on their own. They can help in screening and identifying potential cases for further evaluation but cannot confirm the diagnosis without a biopsy. Option B) IgM anti-reticulin antibodies are not commonly used in the diagnosis of coeliac disease. IgA-based tests are preferred due to the high prevalence of IgA deficiency in individuals with coeliac disease, which could lead to false-negative results with IgM antibodies. In an educational context, understanding the rationale behind diagnostic tests is essential for nurses caring for pediatric patients with coeliac disease. Knowing the limitations and strengths of each test can guide clinical decision-making and ensure appropriate management strategies are implemented. The emphasis on the duodenal biopsy as the definitive diagnostic tool highlights the importance of a comprehensive approach to pediatric pharmacology and nursing care.

Correct Answer: C

Rationale: In pediatric HIV infection, developmental delay is a recognized presentation (Option C). This is the correct answer because HIV can affect the central nervous system in children, leading to developmental delays. Early recognition of this symptom is crucial for timely intervention and management. Option A is incorrect because pediatric HIV infection differs from adult HIV infection not only in mode of transmission but also in clinical presentation, progression, and management strategies. It is not just a matter of differing transmission routes. Option B is incorrect because antenatal screening of pregnant women for HIV is of proven benefit in preventing mother-to-child transmission. Early detection allows for interventions to reduce the risk of vertical transmission. Option D is incorrect because in pediatric HIV cases, early initiation of management is crucial for improving outcomes. Diagnosis and management should proceed simultaneously to provide timely treatment and support for the child and family. Understanding these nuances in pediatric HIV infection is vital for nurses caring for children with this condition. Recognizing developmental delays as a possible presentation, advocating for antenatal screening, and initiating management promptly are essential components of providing comprehensive care for pediatric patients with HIV.

Correct Answer: C

Rationale: The correct answer is C) 5-year-old with difficulty in reading sentences from a book. This child is abnormal because at 5 years old, they should be able to read and understand simple sentences. Reading sentences from a book is an age-appropriate developmental milestone for a 5-year-old, so difficulty in doing so raises concerns about their language and cognitive development. Option A) 18-month-old who can put three blocks on top of each other and has a 2-word vocabulary is normal for that age. By 18 months, children typically have a small vocabulary and are beginning to stack blocks. Option B) A 3-month-old who has good head control and is reaching for objects is also normal. At 3 months, infants start to gain head control and show interest in reaching for objects as part of their motor development. Option D) A bottom-shuffler who is not walking at 16 months is not necessarily abnormal. Children develop at different rates, and some may start walking later than others without it being a cause for concern. Educationally, understanding developmental milestones is crucial for healthcare providers working with pediatric patients. Recognizing abnormal development can lead to early intervention and support for children who may need additional assistance in achieving their milestones. It is essential for nurses to be able to identify deviations from the norm to provide appropriate care and support for pediatric patients and their families.

Correct Answer: A

Rationale: In pediatric nursing pharmacology, understanding how different drugs impact hepatic enzymes is crucial for safe and effective medication administration. In this scenario, the correct answer is A) Rifampicin. Rifampicin is known to induce hepatic enzymes, particularly cytochrome P450 enzymes, which can increase the metabolism of other drugs and lead to decreased drug concentrations in the body. Option B) Phenobarbitone is also a drug that induces hepatic enzymes, specifically cytochrome P450 enzymes. Phenobarbitone is commonly used in pediatric patients for seizure control. Option C) Cimetidine is incorrect because it is actually a cytochrome P450 enzyme inhibitor, which can lead to increased drug concentrations when co-administered with other drugs metabolized by the same enzymes. Option D) Erythromycin does not induce hepatic enzymes. Instead, it is known to inhibit certain cytochrome P450 enzymes, leading to potential drug interactions when used concomitantly with other medications metabolized by the same enzymes. Understanding which drugs induce or inhibit hepatic enzymes is vital for pediatric nurses to prevent adverse drug interactions and ensure optimal therapeutic outcomes for their young patients. This knowledge helps in making informed decisions regarding medication selection, dosing, and monitoring in pediatric cardiovascular care.

Correct Answer: A

Rationale: In the context of pediatric nursing and pharmacology, understanding the causes of a dilated renal pelvis in a fetal scan is crucial for identifying potential issues in prenatal development. In this case, the correct answer is A) Normal variant. The dilation of the renal pelvis in a fetal scan can often be a normal variant and not indicative of any pathology. This physiological dilatation usually resolves on its own as the fetus develops, making it a common finding in routine prenatal scans. Understanding this normal variant helps prevent unnecessary parental anxiety and medical interventions. Option B) Vesico-ureteric reflux and Option C) Pelvi-ureteric junction obstruction are both pathological conditions that can cause a dilated renal pelvis in a fetal scan. Vesico-ureteric reflux is a condition where urine flows backward from the bladder to the ureters and kidneys, leading to renal pelvis dilation. Pelvi-ureteric junction obstruction is a blockage at the connection point between the renal pelvis and the ureter, causing dilation. Option D) Multicystic kidney is a congenital condition characterized by the presence of multiple cysts in the kidney, which can lead to enlargement of the affected kidney but not necessarily cause dilation of the renal pelvis in a fetal scan. Educationally, this question highlights the importance of differentiating between normal variants and pathological conditions in fetal scans, emphasizing the need for nurses to have a strong foundation in pediatric pharmacology to provide accurate patient care and education to families.