The absence of dermal symptoms does not exclude anaphylaxis, because patients who present with cutaneous symptoms (urticaria, angioedema, flushing, warmth) are

Correct Answer: B

Rationale: The correct answer is B) 90%. In pediatric nursing, it is crucial to understand the manifestations of anaphylaxis, as timely recognition and intervention are vital in saving a child's life. While some may associate anaphylaxis primarily with dermal symptoms like hives and swelling, it is essential to know that the absence of these skin symptoms does not rule out anaphylaxis. The correct answer, 90%, highlights that a significant proportion of patients who present with anaphylaxis may not exhibit dermal symptoms. This underscores the importance of considering anaphylaxis in the differential diagnosis even in the absence of typical skin manifestations. Option A) 50%, Option C) 70%, and Option D) 80% are incorrect because they suggest a lower likelihood of patients presenting without dermal symptoms in anaphylaxis cases. Understanding that the absence of skin symptoms does not exclude anaphylaxis is critical for healthcare providers to prevent delays in diagnosis and treatment. Educationally, this question emphasizes the need for nurses to have a broad understanding of anaphylaxis presentations beyond just dermal symptoms. It encourages critical thinking and challenges assumptions, preparing nurses to provide comprehensive care to pediatric patients in various clinical scenarios.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the inheritance patterns of genetic conditions is crucial for providing effective care to pediatric patients. Complete androgen insensitivity syndrome (CAIS) is a genetic condition where individuals with XY chromosomes are unable to respond to androgens, resulting in physical characteristics of females. The inheritance pattern of CAIS is X-linked recessive. The correct answer, option D, X-linked recessive, is the right choice because the gene responsible for CAIS is located on the X chromosome. Males have only one X chromosome, so if they inherit the affected X chromosome, they will have the condition. Females have two X chromosomes, so they would need to inherit two affected X chromosomes to manifest CAIS. Options A, B, and C can be ruled out as incorrect because CAIS does not follow an autosomal dominant, autosomal recessive, or mitochondrial inheritance pattern. Autosomal dominant conditions typically do not skip generations, which is not the case with CAIS. Autosomal recessive conditions require two copies of the gene to be affected, which is not applicable to CAIS in females. Mitochondrial inheritance is passed from mother to all offspring and does not involve the X chromosome like CAIS. Educationally, understanding the inheritance patterns of genetic conditions like CAIS helps pediatric nurses provide comprehensive care, anticipate potential complications, and offer appropriate support to patients and families. It also underscores the importance of genetic counseling and family education in managing genetic conditions in pediatric patients.

Correct Answer: D

Rationale: In pediatric nursing, understanding atopic dermatitis is crucial for providing effective care to children. In this case, the correct answer is D) blanching after intradermal histamine injection. This is because atopic dermatitis is associated with an increased response to histamine, leading to blanching upon injection due to increased capillary permeability. Option A) Wheel and flare reaction after intradermal injection of an allergen is often seen in patients with atopic dermatitis due to their hyperreactivity to allergens, making it a common feature of the condition. Option B) White dermographism refers to the skin reaction where pressure on the skin leads to white lines, which can be present in patients with atopic dermatitis due to their skin hypersensitivity. Option C) Abnormal rates of cooling are not specific to atopic dermatitis and are not a characteristic feature of this condition. Educationally, understanding these skin manifestations in atopic dermatitis helps nurses in early identification, management, and education of patients and families. By differentiating these skin responses, nurses can provide tailored care plans and educate on triggers and symptom management effectively.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) theophylline toxicity. Theophylline is a medication commonly prescribed for asthma, and vomiting can be a sign of toxicity. It is crucial for healthcare providers to recognize and differentiate between normal side effects and signs of toxicity when managing pediatric patients. Option A) provocation by coughing is incorrect because vomiting related to coughing would be more likely to occur immediately following a coughing spell rather than intermittently over a period of time. Option B) infection is unlikely to be the cause of vomiting in this case since the child has had a limited number of wheezing episodes and the focus is on theophylline treatment. Option D) albuterol toxicity is also an unlikely cause of vomiting in this scenario, as albuterol is a different medication commonly used to treat asthma symptoms, and the focus of the question is on theophylline treatment. Educationally, this question highlights the importance of monitoring for medication side effects and toxicity in pediatric patients with chronic conditions like asthma. It emphasizes the need for healthcare providers to be vigilant in assessing and managing potential adverse effects of medications to ensure the safety and well-being of pediatric patients.

Correct Answer: C

Rationale: The correct answer is C) Begin seasonal use of topical corticosteroids. Topical corticosteroids are the recommended treatment for allergic rhinitis in children due to their effectiveness in reducing inflammation in the nasal passages. They help alleviate symptoms such as watery rhinorrhea, sneezing, and nasal congestion by targeting the underlying inflammatory response triggered by allergens. Option A) Institute strict measures to avoid outdoor allergen exposure may help reduce symptoms, but it is often impractical to completely avoid allergen exposure, especially for outdoor allergens like pollen. Option B) Beginning seasonal use of sympathomimetic drugs may provide temporary relief of symptoms like nasal congestion, but they do not address the underlying inflammation and are not the first-line treatment for allergic rhinitis in children. Option D) Prescribing amoxicillin for 10 days is not appropriate for allergic rhinitis, as it is an antibiotic used to treat bacterial infections, not allergic reactions. In an educational context, it is crucial for healthcare providers to understand the appropriate management of allergic rhinitis in children to provide optimal care and improve patient outcomes. Topical corticosteroids are safe and effective when used as directed, making them a cornerstone in the treatment of allergic rhinitis in pediatric patients. Understanding the rationale behind the treatment options helps healthcare professionals make informed decisions and provide evidence-based care.