The best choice of antibiotic in treating localized impetiginous lesions in patients with atopic dermatitis is

Correct Answer: C

Rationale: In pediatric nursing, it is crucial to understand the appropriate management of impetiginous lesions in patients with atopic dermatitis. The best choice of antibiotic in this scenario is topical mupirocin (Option C). Mupirocin is effective against Staphylococcus aureus and Streptococcus pyogenes, which are common pathogens in impetigo. Topical mupirocin is preferred over oral antibiotics like erythromycin (Option A) and cephalexin (Option B) because it provides targeted therapy directly to the affected skin without the systemic side effects associated with oral antibiotics. Choosing topical ampicillin (Option D) is incorrect as ampicillin is not commonly used to treat impetiginous lesions and may not provide adequate coverage against the pathogens involved. Educationally, understanding the rationale behind selecting specific antibiotics for pediatric skin conditions is essential for nursing practice. It ensures safe and effective care for pediatric patients, minimizes the risk of antibiotic resistance, and promotes evidence-based decision-making in clinical scenarios.

Correct Answer: B

Rationale: In pediatric nursing, understanding ocular allergies is crucial for providing quality care to children. The correct answer, vernal keratoconjunctivitis (option B), is the most sight-threatening type of ocular allergy due to its potential to cause corneal damage and visual impairment. Vernal keratoconjunctivitis is a chronic allergic eye disease that primarily affects children and is characterized by intense itching, photophobia, and mucous discharge. Contact allergy (option A) typically presents with localized symptoms upon exposure to an allergen, such as redness and swelling, but it is not known to be as sight-threatening as vernal keratoconjunctivitis. Giant papillary conjunctivitis (option C) is often associated with contact lens wear and is characterized by papillae formation on the upper tarsal conjunctiva, leading to discomfort and blurry vision, but it is not as severe as vernal keratoconjunctivitis. Seasonal allergic conjunctivitis (option D) is a common allergic condition characterized by redness, itching, and tearing of the eyes during specific seasons, but it is generally milder than vernal keratoconjunctivitis. Educationally, it is important for pediatric nurses to be able to differentiate between various types of ocular allergies to provide appropriate care and management. Recognizing the signs and symptoms of vernal keratoconjunctivitis is essential for early intervention to prevent potential vision complications in pediatric patients. Nurses should also educate caregivers on allergen avoidance, proper eye hygiene, and medication management to effectively support children with ocular allergies.

Correct Answer: D

Rationale: In pediatric nursing, understanding the differential diagnosis of chronic urticaria is crucial for accurate assessment and treatment. In this case, the correct answer is D) cutaneous blistering disorders. Cutaneous blistering disorders are not typically associated with chronic urticaria, which is characterized by hives or wheals. On the other hand, options A, B, and C are all related to mast cell disorders or malignancies that can manifest with urticaria symptoms. Cutaneous mastocytosis and systemic mastocytosis involve abnormal mast cell proliferation, leading to urticaria. Complement-mediated mast cell degranulation in malignancies can also present with urticaria due to mast cell activation. Educationally, this question highlights the importance of recognizing different conditions that can present similarly in pediatric patients. By understanding the nuances of each differential diagnosis, nurses can provide targeted care and interventions to manage chronic urticaria effectively. It also underscores the significance of thorough assessment and critical thinking in pediatric nursing practice.

Correct Answer: B

Rationale: In serum sickness, which is a type III hypersensitivity reaction, the body produces immune complexes in response to a foreign serum or substance. Thrombocytosis, or an elevated platelet count, is unlikely in serum sickness because this condition primarily involves the immune system and not the hematologic system. A) An elevated erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation, which would be expected in serum sickness due to the immune response causing tissue inflammation. C) Reduced C3 activity is likely in serum sickness because immune complexes can activate the complement system, leading to a decrease in complement levels. D) Negative microbial cultures are expected in serum sickness because it is not caused by an infectious microorganism, but rather by an immune response to a foreign substance. Educationally, understanding the pathophysiology of serum sickness and how it differs from other conditions is crucial for nurses caring for pediatric patients. Recognizing the clinical manifestations and laboratory findings associated with serum sickness can aid in prompt diagnosis and appropriate management to prevent complications.

Correct Answer: D

Rationale: In pediatric nursing, understanding vaccine contraindications is crucial for safe and effective patient care. The correct answer is D) yellow fever. Yellow fever vaccine is contraindicated in children with egg allergy due to the vaccine containing egg protein. Children with egg allergy are at risk of an allergic reaction when exposed to egg proteins in vaccines, making the administration of the yellow fever vaccine unsafe for them. Option A) MMR, Option B) influenza, and Option C) DPT are not contraindicated in children with egg allergy. The MMR (measles, mumps, rubella) vaccine, influenza vaccine, and DPT (diphtheria, pertussis, tetanus) vaccine do not contain egg proteins in amounts sufficient to cause an allergic reaction in children with egg allergy. Therefore, these vaccines are considered safe for administration in children with egg allergy. Educationally, understanding vaccine contraindications based on allergies is essential for pediatric nurses to provide safe care to their patients. Nurses must assess each child's medical history, including allergies, before administering vaccines to prevent adverse reactions. This knowledge ensures that vaccines are administered safely and effectively, contributing to improved patient outcomes and overall public health.