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 essential to understand the appropriate management of skin conditions like impetigo in patients with atopic dermatitis. The correct choice of antibiotic in treating localized impetiginous lesions in these patients is topical mupirocin (Option C). Here's the rationale: Topical mupirocin is the best choice because it is effective against the most common pathogens causing impetigo, such as Staphylococcus aureus and Streptococcus pyogenes. It provides targeted treatment to the affected area, minimizing systemic effects and reducing the risk of antibiotic resistance. Oral erythromycin (Option A) is less effective against the bacteria commonly involved in impetigo. Oral cephalexin (Option B) may be more appropriate for deeper skin infections but is not the first-line treatment for impetigo. Topical ampicillin (Option D) is not a recommended treatment for impetigo due to its limited spectrum of activity and the availability of more effective alternatives like mupirocin. Educationally, understanding the rationale behind antibiotic choices in pediatric dermatology is crucial for providing safe and effective care to patients. It highlights the importance of evidence-based practice and tailoring treatment to the specific characteristics of each case, promoting better outcomes and minimizing adverse effects.

Correct Answer: B

Rationale: In pediatric nursing, understanding ocular allergies is crucial for providing optimal care to young patients. The correct answer is B) vernal keratoconjunctivitis. This type of ocular allergy is the most sight-threatening because it can lead to serious complications such as corneal ulcers and vision impairment if left untreated. Vernal keratoconjunctivitis is a chronic, severe allergic conjunctivitis that primarily affects children and adolescents with a family history of allergies. Option A) contact allergy is not the most sight-threatening type of ocular allergy. While contact allergies can cause discomfort and irritation, they are typically localized and do not pose significant risks to vision compared to vernal keratoconjunctivitis. Option C) giant papillary conjunctivitis is characterized by inflammation of the conjunctiva due to chronic irritation, often caused by contact lens wear. While it can lead to discomfort and blurred vision, it is not considered as sight-threatening as vernal keratoconjunctivitis. Option D) seasonal allergic conjunctivitis refers to allergic reactions triggered by seasonal allergens such as pollen. While it can cause significant discomfort and affect quality of life, it is generally less severe and sight-threatening compared to vernal keratoconjunctivitis. Educationally, understanding the different types of ocular allergies and their respective risks is essential for pediatric nurses to accurately assess and manage ocular conditions in young patients. Recognizing the severity of vernal keratoconjunctivitis highlights the importance of early identification and appropriate treatment to prevent long-term complications and preserve vision.

Correct Answer: D

Rationale: In the case of chronic urticaria, the correct answer is option D) cutaneous blistering disorders. The reason this is the correct answer is that chronic urticaria is characterized by hives or wheals on the skin that are typically associated with itching and can be caused by various factors such as allergies, infections, or autoimmune diseases. Cutaneous blistering disorders, on the other hand, present with blisters on the skin, which is a different clinical manifestation than urticaria. Option A) cutaneous mastocytosis and option B) systemic mastocytosis are both types of mast cell disorders that can present with skin manifestations similar to urticaria. Mastocytosis involves an abnormal accumulation of mast cells in the skin and other organs, leading to symptoms like hives, itching, and flushing, which can be mistaken for urticaria. Option C) complement-mediated mast cell degranulation in malignancies is a rare condition where certain cancers can trigger mast cell degranulation through the complement system, leading to symptoms similar to urticaria. This option is included in the list of differentials for chronic urticaria because it highlights the importance of considering underlying malignancies in patients presenting with chronic skin symptoms. In an educational context, understanding the differential diagnosis of chronic urticaria is crucial for nurses caring for pediatric patients. By differentiating between various conditions that can mimic urticaria, nurses can provide appropriate care, treatment, and referrals for pediatric patients with skin manifestations. This knowledge helps in accurate assessment, diagnosis, and management of pediatric patients with skin conditions, improving patient outcomes and quality of care.

Correct Answer: B

Rationale: In serum sickness, an immune complex-mediated hypersensitivity reaction, the correct answer is B) thrombocytosis. Thrombocytosis, an elevated platelet count, is not a typical finding in serum sickness. A) Elevated erythrocyte sedimentation rate (ESR) is often seen in inflammatory conditions but is not specific to serum sickness. C) Reduced C3 activity is expected in serum sickness due to complement activation. D) Negative microbial cultures are common in serum sickness as it is not caused by a microorganism. Educationally, understanding the laboratory findings in serum sickness is crucial for nurses caring for pediatric patients. Recognizing these patterns can aid in prompt diagnosis and appropriate management to alleviate symptoms and prevent complications.

Correct Answer: D

Rationale: In pediatric nursing, understanding contraindications for vaccine administration is crucial to ensure the safety and well-being of children. The correct answer is D) yellow fever. Yellow fever vaccine is contraindicated in children with egg allergy due to the potential for allergic reactions since the vaccine is produced in eggs. Influenza vaccine (option B) can be administered to children with egg allergies as long as certain precautions are taken, such as using vaccines with low egg protein content or administering in a medical setting equipped to manage potential allergic reactions. MMR vaccine (option A) and DPT vaccine (option C) do not contain egg proteins in their formulations, so they are safe to administer to children with egg allergies. It is important for healthcare providers to be aware of specific vaccine ingredients and contraindications to provide safe and effective care to their pediatric patients. Educationally, this question highlights the importance of recognizing contraindications for specific vaccines based on individual patient characteristics. It emphasizes the need for healthcare professionals to stay updated on vaccine guidelines and recommendations to make informed decisions regarding vaccination in children with allergies. This knowledge ensures the delivery of appropriate care and contributes to positive health outcomes for pediatric patients.