The commonest affected part of GIT by tuberculosis is:

Correct Answer: A

Rationale: The correct answer is A) Terminal part of small intestine. Tuberculosis can affect various parts of the body, including the gastrointestinal tract. In pediatric patients, the terminal part of the small intestine is commonly affected by gastrointestinal tuberculosis. This area is susceptible to infection due to its rich blood supply and lymphatic drainage. Option B) Terminal part of esophagus is incorrect because esophageal tuberculosis is rare compared to involvement of the small intestine in tuberculosis cases. Option C) Terminal part of large intestine is incorrect as tuberculosis more commonly affects the small intestine rather than the large intestine in the pediatric population. Option D) Pylorus is incorrect as tuberculosis primarily affects the small intestine and not specifically the pylorus. In an educational context, understanding the common manifestations of tuberculosis in different parts of the body is crucial for healthcare providers, especially pediatric nurses. Knowing the typical sites of tuberculosis infection in the gastrointestinal tract can aid in early recognition, diagnosis, and appropriate management of the disease in pediatric patients.

Correct Answer: D

Rationale: In this question, the correct answer is D) Acute rheumatic fever recurrence. The Jones criteria are a set of guidelines used to help diagnose acute rheumatic fever, a condition that can follow an untreated streptococcal infection. One of the major criteria in the Jones criteria is the history of acute rheumatic fever or its recurrence. Therefore, adherence to the Jones criteria is necessary to diagnose acute rheumatic fever recurrence accurately. Now, let's analyze why the other options are incorrect: A) Chorea: While chorea is one of the major manifestations of acute rheumatic fever, it is not specifically mentioned in the Jones criteria for diagnosis. B) Indolent carditis: Carditis is indeed a major criterion in the Jones criteria, but the term "indolent" does not align with the acute nature of rheumatic fever. C) Subcutaneous nodules: Subcutaneous nodules are also a major criterion in the Jones criteria, but they are not directly linked to the need for adherence specifically in diagnosing acute rheumatic fever recurrence. Educational Context: Understanding the Jones criteria is crucial for healthcare professionals, especially those working with pediatric patients. By knowing the criteria and the significance of each component, nurses can accurately assess and diagnose acute rheumatic fever in children. This knowledge helps in providing timely and appropriate treatment to prevent complications and long-term sequelae associated with the condition. Regular review and application of the Jones criteria in clinical practice can improve patient outcomes and reduce the burden of rheumatic heart disease in pediatric populations.

Correct Answer: D

Rationale: Innocent heart murmurs are benign murmurs commonly heard in children with structurally normal hearts. These murmurs are typically soft, systolic, and do not signify any underlying heart disease. Therefore, children with innocent murmurs do not require any specific interventions or restrictions. Option A, restriction of exercise, is incorrect because children with innocent murmurs do not need to limit physical activity as these murmurs do not pose a risk during exercise. Option B, antibiotic prophylaxis against infective endocarditis, is unnecessary in children with innocent murmurs as these murmurs are not associated with an increased risk of infective endocarditis. Option C, an initial echocardiographic tracing to rule out structural heart disease, is also not indicated for innocent murmurs. Innocent murmurs are diagnosed based on characteristic auscultation findings and a thorough clinical evaluation, without the need for further imaging studies in the absence of concerning symptoms or signs of heart disease. Educationally, understanding the characteristics and management of innocent heart murmurs is crucial for healthcare providers working with pediatric populations. By differentiating innocent murmurs from pathological murmurs, healthcare providers can avoid unnecessary interventions, reduce parental anxiety, and provide appropriate care for children with innocent murmurs. Regular auscultation and clinical assessment are key components of pediatric care to identify and appropriately manage innocent murmurs.

Correct Answer: C

Rationale: In the initial treatment of rheumatic fever with severe carditis and congestive heart failure, the correct answer is C) Acetylsalicylic acid 100 mg/kg/day in 4 divided doses. This is because acetylsalicylic acid is contraindicated in the presence of viral infections, especially in children due to the risk of Reye's syndrome. Option A, Benzathine benzyl penicillin 1.2 mega unit, is commonly used to treat streptococcal infections associated with rheumatic fever. Option B, complete bed rest, is also a standard recommendation to reduce cardiac workload and prevent further complications. Option D, Prednisolone 2 mg/kg/day in 3 divided doses, is used in the presence of severe carditis but should be carefully monitored due to potential side effects such as immunosuppression. Educationally, understanding the rationale behind each treatment option is crucial for pediatric nurses to provide safe and effective care to children with rheumatic fever. It is essential to consider contraindications, appropriate dosages, and potential adverse effects when managing these complex cases.

Correct Answer: B

Rationale: In the management of newly diagnosed bronchial asthma with occasional symptoms, the most appropriate treatment is a low dose inhaled corticosteroid (ICS), which is option B. The rationale behind this is that ICS is recommended as first-line therapy for asthma due to its anti-inflammatory effects, which help to reduce airway inflammation and prevent symptoms. It is effective in controlling asthma symptoms and reducing the frequency and severity of asthma attacks. Inhaled short-acting B2 agonists (option A) are used for quick relief of acute symptoms but are not recommended as monotherapy for long-term asthma control. Anti-leukotrienes (option C) are typically used as adjunctive therapy for asthma and not as first-line treatment. Slow-release theophylline (option D) is less commonly used now due to its narrow therapeutic window and potential for toxicity. From an educational perspective, understanding the rationale behind the choice of treatment is crucial for nursing students to provide safe and effective care to pediatric patients with asthma. It is important for students to grasp the principles of asthma management, including the use of ICS as a cornerstone of treatment, to ensure optimal outcomes for their patients. By explaining the reasons why certain options are correct or incorrect, students can develop a deeper understanding of the pharmacological management of asthma and make informed clinical decisions in their practice.