The causes of elevated maternal serum AFP are:

Correct Answer: D

Rationale: In this question, the correct answer is option D) Meningomyelocele. Elevated maternal serum alpha-fetoprotein (AFP) levels are associated with neural tube defects such as meningomyelocele. AFP is produced by the fetal liver and yolk sac, and elevated levels can indicate issues with the developing fetus. Option A) Trisomy 21 is incorrect because it is associated with elevated maternal serum human chorionic gonadotropin (hCG), not AFP. Option B) Exomphalos is incorrect because it is associated with defects in the abdominal wall, not with elevated AFP levels. Option C) Marfan syndrome is incorrect as it is a genetic connective tissue disorder and is not related to elevated AFP levels. In the context of pediatric nursing, understanding the significance of maternal serum AFP levels can help nurses in assessing the risk of neural tube defects in the fetus. This knowledge is crucial for providing appropriate prenatal care and counseling to families. It also highlights the importance of early detection and intervention in cases of neural tube defects.

Correct Answer: D

Rationale: In this question, the correct answer is D) Are associated with other generalised seizures in most cases. Generalized absence seizures are typically associated with other types of generalized seizures, such as tonic-clonic seizures. This association is important for healthcare providers to recognize because it can impact the overall management and treatment approach for the patient. Option A) Are usually atypical in type is incorrect because generalized absence seizures are typically considered typical, characterized by a brief loss of awareness or responsiveness. Option B) CT scan shows abnormalities in around 25-30% of cases is incorrect because absence seizures do not typically show structural abnormalities on imaging studies like CT scans. They are usually diagnosed based on clinical presentation and EEG findings. Option C) Can be diagnosed in the absence of a typical EEG pattern with great certainty is incorrect because EEG findings are crucial in diagnosing absence seizures. A typical EEG pattern showing generalized spike-and-wave discharges is often required for a definitive diagnosis. Educationally, understanding the characteristics and associations of different types of seizures, including generalized absence seizures, is vital for healthcare providers, especially those working with pediatric patients. Recognizing the typical features and diagnostic criteria for absence seizures can lead to appropriate management strategies and improved outcomes for patients.

Correct Answer: B

Rationale: In an acute anaphylactic reaction to a blood transfusion in pediatrics, the appropriate initial management steps should focus on stabilizing the patient's condition. Option B, Oxygen, is the correct choice as it is crucial in ensuring adequate oxygenation to prevent hypoxia, which is a life-threatening complication of anaphylaxis. Providing supplemental oxygen helps maintain tissue perfusion and supports vital organ function during the acute phase of an anaphylactic reaction. Nebulised steroids (Option A) are not typically recommended as an initial management step in acute anaphylaxis. Steroids may be used later in the treatment process for their anti-inflammatory effects, but they are not considered first-line therapy for immediate symptom relief in anaphylactic reactions. Intravenous hydrocortisone (Option C) may be beneficial in managing anaphylaxis, but it is not the initial step in addressing acute symptoms. Corticosteroids are used for their anti-inflammatory properties and are usually administered after stabilizing the patient's condition with interventions like oxygen and epinephrine. Intravenous anti-H2 agents (Option D) are not indicated in the initial management of anaphylactic reactions. Anti-H2 agents are more commonly used to reduce gastric acid production and are not considered a standard treatment for anaphylaxis. In an educational context, it is essential for healthcare providers, especially nurses, to be well-versed in recognizing and managing anaphylactic reactions promptly, particularly in pediatric patients who may have unique needs and vulnerabilities. Understanding the appropriate sequence of interventions and their rationale is crucial for ensuring optimal patient outcomes in emergency situations.

Correct Answer: B

Rationale: In this question, the correct answer is B) Epiglottitis. Epiglottitis is a serious condition in pediatrics that can cause upper airway obstruction due to inflammation and swelling of the epiglottis, leading to potential life-threatening respiratory distress. Option A) Inhaled foreign body in the main bronchus on the right side is incorrect because while foreign body aspiration can cause airway obstruction, it typically presents with symptoms such as cough, wheezing, and unilateral decreased breath sounds rather than upper airway obstruction. Option C) Retropharyngeal abscess is incorrect as it can cause difficulty swallowing and neck stiffness but is less likely to cause upper airway obstruction compared to epiglottitis. Option D) Viral croup is incorrect as it typically presents with a barking cough and inspiratory stridor but does not typically cause severe upper airway obstruction as seen in epiglottitis. Educationally, understanding the different causes of upper airway obstruction in pediatric patients is crucial for nurses as they may encounter such emergencies in clinical practice. Recognizing the signs and symptoms of epiglottitis and differentiating it from other conditions is essential for prompt intervention and management to prevent respiratory compromise.

Correct Answer: D

Rationale: The correct answer is D) Is part of humoral immunity. The complement system is a crucial part of the innate immune response and plays a significant role in humoral immunity. It consists of a group of proteins that work together to enhance the ability of antibodies and phagocytic cells to clear pathogens. The complement system can be activated through three pathways: classical, lectin, and alternative. While bacterial endotoxins activate the system through the alternative pathway, not the classical pathway as mentioned in option A. Option B is incorrect because reduced C3 and C4 are not typical findings in acute glomerulonephritis. Option C is incorrect as hereditary angioedema is caused by deficiency in C1 inhibitor, which is part of the classical pathway, not the complement system. Understanding the complement system is essential in pharmacology as it is a target for various therapeutic interventions in treating immune-related conditions.