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

Correct Answer: D

Rationale: In the management of step-6 severe persistent asthma in a 6-year-old boy, the best treatment option is D) high-dose inhaled corticosteroids with long-acting B-agonist and oral corticosteroids along with omalizumab therapy. This comprehensive approach is necessary to address the severity of the condition and achieve optimal control. High-dose inhaled corticosteroids with long-acting B-agonists help to reduce inflammation and provide bronchodilation. Oral corticosteroids may be required during exacerbations to control symptoms and prevent further complications. Omalizumab, a monoclonal antibody, is recommended for children with severe allergic asthma to target specific immune responses. The other options are suboptimal for step-6 severe persistent asthma. Option A lacks the addition of oral corticosteroids and omalizumab, which are crucial for severe cases. Option B includes a leukotriene receptor antagonist instead of omalizumab, which may not be as effective in severe asthma. Option C suggests low-dose inhaled corticosteroids, which are insufficient for managing severe persistent asthma in this age group. Educationally, understanding the stepwise approach to asthma management in children is vital for healthcare providers caring for pediatric patients. It highlights the importance of individualized treatment plans based on disease severity and the need for a multidisciplinary approach in managing complex cases like severe persistent asthma.

Correct Answer: D

Rationale: In pediatric nursing, understanding the relationship between certain conditions and vitamin deficiencies is crucial for providing holistic care to children. In the context of severe atopic dermatitis, which is a chronic inflammatory skin condition common in children, the correct answer is option D) Vitamin D deficiency. Atopic dermatitis is associated with impaired skin barrier function, leading to increased loss of water through the skin. This can result in decreased production of vitamin D in the skin upon exposure to sunlight, exacerbating the deficiency. Vitamin D plays a crucial role in immune regulation and maintaining skin health, making it particularly important in conditions like atopic dermatitis. 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 important for collagen synthesis and immune function, but its deficiency is not directly related to this skin condition. Option C) Vitamin A deficiency is more commonly associated with conditions like night blindness and immune system impairment, rather than atopic dermatitis. Educationally, understanding these associations between specific vitamin deficiencies and pediatric conditions is essential for nurses caring for children with complex health needs. By grasping the underlying mechanisms, nurses can provide targeted interventions to improve outcomes and quality of life for pediatric patients with atopic dermatitis and other conditions.

Correct Answer: C

Rationale: In pediatric nursing, it is crucial to understand the different reactions children may have to insect stings and bites. The correct answer is C) a pronounced systemic reaction due to immediate hypersensitivity. This is because children, especially those with allergies, can have severe allergic reactions known as anaphylaxis when exposed to insect venom. This can lead to life-threatening symptoms such as difficulty breathing, swelling, and a drop in blood pressure. Option A) a limited lesion confined to the primary site is incorrect because it describes a localized reaction that is not indicative of a systemic response. Option B) a pronounced localized reaction also does not capture the potential for a systemic reaction that can occur in severe cases of insect stings or bites. Option D) a pronounced systemic reaction due to delayed hypersensitivity is incorrect as most reactions to insect venom in children occur rapidly due to immediate hypersensitivity mechanisms. Educationally, it is important for pediatric nurses to be able to recognize the signs and symptoms of allergic reactions to insect stings and bites promptly to provide appropriate care and potentially life-saving interventions. Understanding the difference between localized and systemic reactions is critical in ensuring the safety and well-being of pediatric patients.

Correct Answer: A

Rationale: The correct answer is A) conjunctiva. The conjunctiva is the thin, transparent membrane that covers the white part of the eye and lines 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 that respond to allergens. This makes it a common target for allergic reactions due to its direct exposure to environmental allergens and its rich blood supply, which facilitates the immune response. The other options are incorrect because: - B) sclera: The sclera is the tough, white outer layer of the eye that provides structural support. It is not as immunologically active as the conjunctiva. - C) eyelids: While the eyelids can be affected by allergic reactions, they are not as immunologically active as the conjunctiva due to their different tissue composition and function. - D) eyelashes: Eyelashes play a role in protecting the eye from debris and foreign particles but are not immunologically active tissues involved in allergic responses. Educationally, understanding the immunological activity of the conjunctiva is crucial for pediatric nurses as they care for children with allergic eye conditions. Recognizing the role of the conjunctiva in allergic responses can guide nurses in providing appropriate interventions and educating patients and families on allergen avoidance and management strategies.

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 the patient is experiencing a severe anaphylactic reaction, as urticaria is usually self-limited and mild in nature. Epinephrine is reserved for more severe allergic reactions due to its potential side effects and risks. Option A) loratadine and Option B) hydroxyzine are both second-generation antihistamines commonly used to relieve symptoms of urticaria by blocking the effects of histamine. These medications are often recommended for mild to moderate cases of acute urticaria due to their effectiveness and low side effect profile. Option D) H2 antihistamines, such as ranitidine, are not typically used as first-line treatment for acute urticaria. While they may have some benefit in certain cases, they are not as effective as H1 antihistamines like loratadine and hydroxyzine. Educationally, this question highlights the importance of differentiating between the management strategies for various severities of allergic reactions in pediatric patients. Understanding when to use different medications based on the severity of symptoms is essential for providing safe and effective care to children with acute urticaria.