The best treatment option for step-6 severe persistent asthma in a 6-year-old boy is

Correct Answer: D

Rationale: In pediatric nursing, managing asthma in children requires a comprehensive understanding of treatment modalities based on severity. For a 6-year-old with step-6 severe persistent asthma, the best treatment option is option D: high-dose inhaled corticosteroids with long-acting B-agonist and oral corticosteroids along with omalizumab therapy. This option is correct because step-6 severe persistent asthma necessitates aggressive treatment to control symptoms and prevent exacerbations. High-dose inhaled corticosteroids with long-acting B-agonists provide potent anti-inflammatory and bronchodilator effects. Oral corticosteroids help manage acute exacerbations, while omalizumab, a monoclonal antibody, is indicated for severe allergic asthma. Option A is incorrect because medium-dose inhaled corticosteroids may not be sufficient for severe persistent asthma. Option B is insufficient as high-dose inhaled corticosteroids are required for severe asthma. Option C with low-dose inhaled corticosteroids is not appropriate for severe persistent asthma in a 6-year-old. Educationally, understanding asthma severity levels and corresponding treatment strategies is crucial for nursing students caring for pediatric patients. This rationale highlights the importance of tailored, evidence-based approaches in managing pediatric asthma to optimize patient outcomes and quality of life.

Correct Answer: D

Rationale: In pediatric nursing, understanding the relationship between certain conditions and potential deficiencies is crucial for providing comprehensive care to children. In the context of severe atopic dermatitis, the correct answer is option D) Vitamin D deficiency. Atopic dermatitis is a chronic inflammatory skin condition that can be exacerbated by various factors, including vitamin deficiencies. Vitamin D plays a significant role in modulating the immune system and maintaining skin health. Research has shown that individuals with atopic dermatitis often have lower levels of Vitamin D, which can worsen the symptoms of the condition. Option A) Vitamin E deficiency is not typically associated with atopic dermatitis. Vitamin E is more commonly linked to neurological and muscle disorders. Option B) Vitamin C deficiency is not a common accompaniment to atopic dermatitis. Vitamin C is essential for collagen synthesis and immune function but is not specifically tied to this skin condition. Option C) Vitamin A deficiency is known to affect skin health, but it is not the primary deficiency associated with atopic dermatitis. Vitamin A is crucial for vision, immune function, and cellular differentiation. Understanding the correlation between specific vitamin deficiencies and pediatric conditions like atopic dermatitis is vital for nurses caring for children with these complex health needs. By recognizing the role of Vitamin D in exacerbating atopic dermatitis, healthcare providers can implement appropriate interventions to support skin health and overall well-being in pediatric patients.

Correct Answer: C

Rationale: In pediatric nursing, understanding reactions to stinging and biting insects is crucial for providing effective care. The correct answer is C) a pronounced systemic reaction due to immediate hypersensitivity. This is known as an anaphylactic reaction, where the body responds aggressively to the insect's venom, leading to symptoms like hives, swelling, difficulty breathing, and in severe cases, anaphylactic shock. Option A) a limited lesion confined to the primary site is incorrect because insect bites can trigger a more widespread reaction beyond the primary site due to the release of inflammatory mediators. Option B) a pronounced localized reaction is also incorrect as some individuals may experience a systemic response rather than just a localized one. Option D) a pronounced systemic reaction due to delayed hypersensitivity is incorrect because insect bites typically trigger an immediate hypersensitivity response rather than a delayed one. Understanding these different types of reactions is important for nurses to quickly recognize and intervene in cases of severe allergic reactions to insect bites, especially in pediatric patients who may have heightened sensitivities. Educationally, nurses must be equipped with the knowledge to differentiate between local and systemic reactions to insect bites, understand the signs and symptoms of anaphylaxis, and be prepared to administer appropriate treatments such as epinephrine in emergency situations. This knowledge can be life-saving in pediatric nursing practice, where prompt and accurate assessment is crucial.

Correct Answer: A

Rationale: The correct answer is A) conjunctiva. The conjunctiva is the thin, transparent mucous membrane covering the front of the eye and lining the inside of the eyelids. It is the most immunologically active tissue of the external eye because it contains a high density of immune cells, such as mast cells, eosinophils, and lymphocytes, which play a crucial role in initiating and mediating allergic reactions. The other options are incorrect because: - B) Sclera: The sclera is the tough, white outer coat of the eyeball. While it provides structural support to the eye, it is not as immunologically active as the conjunctiva. - C) Eyelids: The eyelids serve a protective function for the eye but do not have the same level of immune activity as the conjunctiva. - D) Eyelashes: Eyelashes help protect the eye from debris and foreign particles but do not have a significant immunological role compared to the conjunctiva. In an educational context, understanding the immunological activity of the conjunctiva is crucial for pediatric nurses caring for children with allergic eye conditions. By knowing that the conjunctiva is the primary site of immune response in the eye, nurses can provide appropriate patient education, identify symptoms early, and implement effective management strategies to alleviate allergic reactions in pediatric patients.

Correct Answer: C

Rationale: In the context of pediatric nursing, understanding the management of acute urticaria is crucial. The correct answer, C) epinephrine IM, is not typically used in the treatment of acute urticaria unless there is an anaphylactic component present. Acute urticaria is usually self-limiting and can be managed with antihistamines like loratadine (A), hydroxyzine (B), and H2 antihistamines (D) to alleviate symptoms of itching and rash. Loratadine (A) is a second-generation antihistamine commonly used in pediatrics due to its efficacy and low risk of sedation. Hydroxyzine (B) is another antihistamine that can be used for its sedating effects in cases where sleep disturbance due to itching is a concern. H2 antihistamines (D) like ranitidine can also be used to complement H1 antihistamines in some cases. It is important for pediatric nurses to be aware of the appropriate pharmacological management of conditions like acute urticaria to provide safe and effective care to pediatric patients. Understanding the indications and contraindications of different medications is essential to ensure optimal outcomes for children experiencing allergic reactions.