The BEST treatment for a 16-year-old female adolescent with Behcet disease involving oral and genital ulcers and erythema nodosum is

Correct Answer: A

Rationale: In treating a 16-year-old female adolescent with Behcet disease involving oral and genital ulcers and erythema nodosum, the BEST treatment is colchicine (Option A). Colchicine is effective in managing the symptoms of Behcet disease by reducing inflammation and preventing flare-ups. It is particularly useful in treating oral and genital ulcers, which are common manifestations of the disease in adolescents. Azathioprine (Option B) and cyclophosphamide (Option C) are immunosuppressants that are usually reserved for more severe cases of Behcet disease or when colchicine is not effective. These medications have more significant side effects and risks compared to colchicine, making them less suitable as the first-line treatment for this adolescent. Steroids (Option D) are not the preferred choice for long-term management of Behcet disease due to their side effects, especially in growing adolescents. While steroids may be used for acute flare-ups, they are not recommended as a primary treatment option in this case. Educationally, understanding the rationale behind choosing colchicine for this adolescent with Behcet disease is crucial for nursing students. It highlights the importance of selecting appropriate treatments based on the patient's age, disease severity, and potential side effects. This knowledge empowers nurses to provide safe and effective care to pediatric patients with complex conditions like Behcet disease.

Correct Answer: A

Rationale: In pediatric nursing, identifying physical signs of abuse is crucial for early intervention and protection of vulnerable children. In this scenario, the correct answer is option A) 5%. Bite marks are a relatively uncommon physical sign of abuse compared to other indicators such as bruises, burns, or fractures. This low prevalence of bite marks as a sign of abuse is why the correct answer is 5%. Option B) 15%, Option C) 25%, and Option D) 35% are incorrect because they overestimate the frequency of bite marks as physical signs of abuse. Understanding the actual prevalence of different physical signs of abuse is essential for healthcare professionals working with children to accurately assess and respond to suspected cases of abuse. Educationally, this question highlights the importance of knowledge and recognition of physical signs of abuse in pediatric patients. It underscores the need for healthcare providers to be vigilant, thorough, and evidence-based in their assessments to ensure the safety and well-being of children under their care. By understanding the rarity of certain signs like bite marks, nurses and other healthcare professionals can better differentiate between accidental injuries and those caused by abuse, leading to appropriate reporting and intervention.

Correct Answer: A

Rationale: In this scenario, the most common possible cause of the 15-month-old child's symptoms (failure to thrive, diarrhea, and fatty stool) is malabsorption (Option A). Malabsorption refers to the inability of the digestive system to properly absorb nutrients from food, leading to nutritional deficiencies and symptoms like those described. Option A is the correct answer because the symptoms of failure to thrive, diarrhea, and fatty stool are classic signs of malabsorption in children. Malabsorption can be due to various conditions such as cystic fibrosis, celiac disease, or short bowel syndrome, which can affect nutrient absorption and result in poor growth and gastrointestinal issues. Option B (intestinal parasites) is less likely in this case as the symptoms described are more indicative of a chronic condition like malabsorption rather than an acute parasitic infection. While intestinal parasites can cause diarrhea and malabsorption, they are not as common a cause in this context. Option C (milk protein intolerance) could present with similar symptoms, but it would typically lead to more immediate gastrointestinal reactions like vomiting and abdominal pain rather than chronic failure to thrive and fatty stool. Option D (pancreatic insufficiency) could also lead to malabsorption due to inadequate enzyme production for digestion, but it is less common in young children and typically presents with other symptoms like steatorrhea (fatty stools) and weight loss. Educationally, understanding the differential diagnosis of failure to thrive in children is crucial for pediatric nurses. Recognizing the signs and symptoms of malabsorption and knowing the common causes can aid in timely diagnosis and appropriate management to improve the child's nutritional status and overall health.

Correct Answer: D

Rationale: In this scenario, the most appropriate step is to intubate the trachea and provide positive-pressure ventilation (Option D). This is because the infant is presenting with significant respiratory distress, as evidenced by hypotonia, cyanosis, apnea, and bradycardia. Intubation allows for a secure airway and the delivery of oxygen and positive-pressure ventilation to support the infant's breathing. Stimulating the infant to breathe (Option A) may not be effective in this case, as the infant is already hypotonic and apneic, indicating a more severe respiratory compromise. Administering epinephrine (Option B) is not the initial intervention for respiratory distress in a newborn. Positive-pressure bag-and-mask ventilation (Option C) could be considered if intubation is not immediately feasible, but given the severity of the infant's condition, intubation for definitive airway management is the most appropriate next step. From an educational perspective, understanding the importance of prompt and appropriate interventions in neonatal resuscitation is crucial for healthcare providers working in labor and delivery settings. Recognizing the signs of respiratory distress in a newborn and knowing the steps to secure the airway and provide ventilation can significantly impact outcomes in these critical situations. Practicing skills such as neonatal intubation and ventilation techniques through simulation and hands-on training can help healthcare providers feel more confident and competent in managing such emergencies.

Correct Answer: C

Rationale: The correct answer is C) A systematic method to assess the newborn at birth. The Apgar score is a quick assessment tool used by healthcare providers to evaluate a newborn's physical condition immediately after birth. It helps determine if the baby needs any immediate medical attention or intervention. The score is based on five criteria: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each criterion is scored from 0 to 2, and the total score ranges from 0 to 10. Option A) A predictor of future development quotients is incorrect because the Apgar score does not predict a child's future development. It is solely a snapshot of the newborn's immediate condition at birth. Option B) A predictor of cerebral palsy is incorrect because the Apgar score does not predict specific long-term outcomes like cerebral palsy. It is a tool for immediate assessment and intervention, not for long-term prognostication. Option D) A predictor of neonatal survival is incorrect because while a low Apgar score may indicate a need for medical intervention to support the newborn's survival, it is not a definitive predictor of survival outcomes. In an educational context, understanding the Apgar score is crucial for pediatric nurses as it guides their initial assessment and care of newborns. It helps them prioritize interventions and communicate effectively with other members of the healthcare team. By mastering the Apgar scoring system, nurses can contribute to improving outcomes for newborns in the critical moments following birth.