The drug of choice for cold-induced urticaria is

Correct Answer: C

Rationale: In the context of pediatric clinical nursing, the drug of choice for cold-induced urticaria is cyproheptadine (option C). Cyproheptadine is a first-generation antihistamine with strong antiserotonergic properties, making it effective in treating cold-induced urticaria which is mediated by histamine release. Option A, loratadine, is a second-generation antihistamine that is more commonly used for allergic conditions but may not be as effective for cold-induced urticaria due to its mechanism of action. Option B, epinephrine, is not typically indicated for cold-induced urticaria as it is mainly used for severe allergic reactions such as anaphylaxis. Option D, diphenhydramine, is another first-generation antihistamine that could provide some relief for urticaria, but cyproheptadine is preferred due to its specific antiserotonergic effects. In an educational context, it is important for pediatric clinical nurse specialists to understand the rationale behind selecting the appropriate medication for different conditions to ensure optimal patient outcomes. Understanding the mechanisms of action of different drugs can help in making informed decisions and providing evidence-based care to pediatric patients with various medical conditions.

Correct Answer: C

Rationale: The correct answer is C) cow's milk. In pediatric clinical practice, food protein-induced enteropathy is a condition where the infant's immune system reacts to certain proteins in the diet, leading to inflammation and damage to the lining of the intestines. Cow's milk is a common trigger for this condition in infants due to its complex proteins that can be challenging for immature digestive systems to break down. Option A) peanuts and Option D) eggs are more commonly associated with food allergies rather than food protein-induced enteropathy. These allergies typically manifest with different symptoms and mechanisms of action compared to enteropathy. Option B) fish is also less likely to be the cause of food protein-induced enteropathy in infants compared to cow's milk. Understanding the common triggers for food protein-induced enteropathy is crucial for pediatric clinical nurse specialists as they play a key role in identifying and managing these conditions in infants. By recognizing the correct triggers and educating caregivers on appropriate dietary modifications, nurse specialists can help improve the health outcomes of these vulnerable patients.

Correct Answer: C

Rationale: In the context of the Pediatric Clinical Nurse Specialist exam, understanding Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) is crucial for providing safe and effective care to pediatric patients. The correct answer is C) allopurinol. Allopurinol is a xanthine oxidase inhibitor used in the treatment of gout and hyperuricemia. It is known to cause DRESS syndrome in some patients. DRESS syndrome is a severe drug reaction characterized by rash, fever, eosinophilia, and systemic organ involvement. Anticonvulsants, sulfonamides, and minocycline are all known culprits in causing DRESS syndrome. Anticonvulsants like carbamazepine and phenytoin, sulfonamides like trimethoprim-sulfamethoxazole, and minocycline, a tetracycline antibiotic, have all been associated with DRESS syndrome in pediatric patients. Educationally, knowing the drugs that can cause DRESS syndrome is essential for nurses to recognize and manage this potentially life-threatening condition promptly. By understanding the specific medications implicated in DRESS syndrome, nurses can advocate for appropriate medication management and provide comprehensive care to pediatric patients experiencing adverse drug reactions.

Correct Answer: A

Rationale: The correct answer is A) 15 to 20 minutes. In vivo skin testing for allergen-specific IgE involves introducing a small amount of allergen under the skin, causing a wheal (raised bump) and flare (redness) reaction if the person is allergic. This reaction is typically measured within 15 to 20 minutes after the allergen is introduced. Option B) 30 to 60 minutes is incorrect because the wheal and flare reaction is usually assessed before this time frame. Option C) 12 to 24 hours is incorrect as this time frame is more indicative of delayed hypersensitivity reactions, not immediate IgE-mediated responses. Option D) 24 to 48 hours is also incorrect as it is too long of a time frame for assessing the immediate wheal and flare reaction associated with IgE-mediated allergies. Understanding the timing of skin testing reactions is crucial for pediatric clinical nurse specialists when assessing and diagnosing allergies in children. Knowing when to expect a reaction allows for timely interpretation and appropriate management. This knowledge aids in providing accurate information to healthcare providers and families, leading to better patient outcomes.

Correct Answer: B

Rationale: The correct answer is B) three or more episodes of wheezing that lasted more than 1 day. Daily long-term control therapy is recommended for infants and young children in this age group who have had three or more episodes of wheezing in the previous year. This recommendation is based on evidence that children who experience frequent wheezing episodes are at higher risk for developing asthma. Option A) two or more episodes is not the correct answer because the threshold for initiating daily long-term control therapy is set at three or more episodes. Option C) four or more episodes and Option D) five or more episodes are also incorrect as they exceed the threshold recommended for initiating daily long-term control therapy in this age group. From an educational perspective, understanding the criteria for initiating daily long-term control therapy in infants and young children is crucial for pediatric clinical nurse specialists. It allows for early intervention and management of asthma symptoms, ultimately improving outcomes for these young patients. Nurses need to be knowledgeable about evidence-based guidelines to provide optimal care to pediatric patients with respiratory conditions.