The first-line therapy of atopic dermatitis (AD) is

Correct Answer: A

Rationale: The correct answer is A) moisturizers. In the management of atopic dermatitis (AD), which is a common chronic inflammatory skin condition in children, the first-line therapy involves maintaining skin hydration and integrity. Moisturizers help to restore the skin barrier function, reduce itching, and prevent flare-ups. They are essential in managing the dryness and itchiness associated with AD. Option B) cyclosporine is not a first-line therapy for AD in children. It is typically reserved for severe cases that do not respond to other treatments due to its potential side effects and long-term risks. Option C) antihistamines may be used to help with itching in AD, but they do not address the underlying issue of skin barrier dysfunction, which is crucial in managing AD effectively. Option D) tar preparations are not typically recommended as first-line therapy for AD in children due to their potential side effects and limited effectiveness compared to other treatment options. In an educational context, understanding the rationale behind using moisturizers as the first-line therapy for AD is essential for healthcare providers working with pediatric patients. By emphasizing the importance of skin barrier repair and hydration, providers can effectively manage AD in children, improve patient outcomes, and educate families on proper skin care practices to prevent flare-ups.

Correct Answer: D

Rationale: In pediatric nursing, understanding indications for venom immunotherapy is crucial for safe and effective care. The correct answer, option D, is the systemic reaction with a positive skin test and negative in vitro test. This indicates a true systemic allergic reaction to a specific venom, warranting venom immunotherapy to desensitize the child to the allergen. Option A, a large local reaction with positive skin and in vitro tests, typically does not warrant venom immunotherapy as it suggests a localized, rather than systemic, reaction. Option B, a generalized cutaneous reaction with a positive skin test and negative in vitro test, also does not meet the criteria for venom immunotherapy as it lacks a systemic component. Option C, a generalized cutaneous reaction with a positive in vitro test and negative skin test, is not indicative of venom immunotherapy as a positive skin test is typically required for diagnosis. Educationally, understanding the nuances of allergic reactions and the specific criteria for venom immunotherapy in pediatric patients ensures accurate assessment and appropriate treatment. Recognizing the combination of systemic symptoms and specific test results is essential for providing optimal care to children with venom allergies.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding the etiology of chronic urticaria is crucial for providing effective care to children. The correct answer is B) systemic lupus erythematosus. Chronic urticaria is a condition characterized by persistent hives lasting more than 6 weeks. In children, systemic lupus erythematosus, an autoimmune disease, can manifest with chronic urticaria as a skin manifestation. This association underscores the importance of considering underlying systemic conditions in the differential diagnosis of chronic urticaria in pediatric patients. Option A) latex is incorrect because while latex allergy can cause acute urticaria, it is less commonly associated with chronic urticaria. Option C) IV immunoglobulin is incorrect as it is often used in the treatment of some autoimmune conditions but is not a common cause of chronic urticaria. Option D) streptococcal pharyngitis is incorrect as it is more likely to present with acute urticaria as a result of an infectious process rather than chronic urticaria. Educationally, understanding the various causes of chronic urticaria in pediatric patients is essential for nurses to provide comprehensive care. By grasping the link between systemic lupus erythematosus and chronic urticaria, nurses can advocate for timely assessments and interventions to address the underlying autoimmune process. This knowledge equips nurses with the ability to collaborate effectively with healthcare teams to ensure accurate diagnosis and management of pediatric patients presenting with chronic urticaria.

Correct Answer: D

Rationale: The correct answer is D) plasma tryptase. Plasma tryptase is the best diagnostic test for anaphylaxis in a child due to its specificity and sensitivity in detecting mast cell activation, which is a key feature of anaphylaxis. Tryptase levels rise early during an anaphylactic reaction and can remain elevated for several hours, making it a reliable marker to confirm the diagnosis. Option A) plasma histamine is not as specific for anaphylaxis as tryptase. Histamine levels can be affected by various factors and may not always correlate with the severity of an allergic reaction. Option B) skin tests are used to identify specific allergens triggering allergic reactions, but they are not diagnostic for anaphylaxis itself. Option C) radioallergosorbent assay (RAST) is a blood test that measures the amount of specific IgE antibodies to particular allergens. While useful for identifying triggers for allergic reactions, it is not specific for diagnosing anaphylaxis. In an educational context, understanding the most appropriate diagnostic tests for anaphylaxis is crucial for pediatric nurses to provide prompt and accurate care to children experiencing severe allergic reactions. Knowledge of specific markers like plasma tryptase can guide clinical decision-making and help in initiating timely interventions to manage anaphylaxis effectively.

Correct Answer: D

Rationale: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated gastrointestinal food hypersensitivity that primarily affects infants and young children. The correct answer, D, "commonly improved with ingestion of soy protein-based formula," is correct because FPIES is commonly triggered by cow's milk or soy proteins. However, using a soy protein-based formula can worsen symptoms in these patients. Option A, "manifests in the first months of life," is a characteristic feature of FPIES as symptoms typically present in infancy. Option B, "vomiting occurs 1-3 hours after feeding," is also a common presentation of FPIES, with delayed onset vomiting being a hallmark symptom. Option C, "hypotension occurs in approximately 15% of cases," is incorrect as hypotension is not a common feature of FPIES; dehydration due to vomiting is more common. Educationally, it is crucial to understand the distinguishing features of FPIES to provide appropriate care and support to affected children and their families. Recognizing the symptoms, triggers, and appropriate management strategies, such as eliminating the offending food proteins, is essential in the nursing care of pediatric patients with FPIES. Additionally, highlighting the potential risks of alternative formulas, like soy-based formulas in FPIES, underscores the importance of accurate nutritional management in these cases.