The following are the major clinical features of atopic dermatitis (AD) EXCEPT

Correct Answer: A

Rationale: Atopic dermatitis (AD) is a common inflammatory skin condition characterized by itchy, red, and inflamed skin. The major clinical features of AD include a family history of atopy (asthma, allergic rhinitis, or eczema), relapsing nature of dermatitis, and facial eczema in infants. Option A, "extensor eczema in adolescents," is incorrect because the typical distribution of eczema in adolescents with AD is actually on flexural areas like the inner elbows and behind the knees. The correct answer is A because extensor eczema is not a major clinical feature of AD, especially in adolescents. Understanding the typical presentation of AD in different age groups is crucial for accurate diagnosis and management in pediatric nursing practice. Educationally, this question helps reinforce the key clinical features of atopic dermatitis, enhancing the learner's ability to differentiate AD from other skin conditions. By explaining the rationale behind the correct answer and why the other options are incorrect, students can deepen their understanding of AD presentations across different age groups, ultimately improving their clinical decision-making skills in pediatric nursing practice.

Correct Answer: B

Rationale: In the context of pediatric nursing practice, it is crucial to understand the diagnostic approach in cases of severe systemic reactions, especially regarding allergy testing. The correct answer, B) repeat skin test after 4-6 weeks, is the most appropriate next step when initial skin tests are negative despite a convincing history of a severe systemic reaction. The rationale behind this is that skin testing may yield false-negative results due to various factors such as medications, age of the patient, or technical errors during the initial test. By repeating the skin test after a few weeks, there is a chance that the immune response has had time to develop, potentially leading to a positive result. Option A) in vitro serum assay for venom-specific IgE may not be as sensitive or specific as repeat skin testing in this scenario. Serum tryptase level (Option C) is useful for assessing mast cell activation but is not the primary diagnostic test for venom allergies. Plasma histamine (Option D) levels are not typically used in the diagnosis of venom allergies in this context. Educationally, understanding the nuances of allergy testing in pediatric patients is vital for nurses to provide safe and effective care. It highlights the importance of considering clinical history alongside diagnostic tests and the need for a comprehensive approach to accurately diagnose and manage allergic reactions in children.

Correct Answer: D

Rationale: In this question, the correct answer is D) giant papillary conjunctivitis. Contact lenses are associated with this condition due to chronic mechanical irritation from the lens surface. Giant papillary conjunctivitis is characterized by inflammation of the inner surface of the eyelids, leading to symptoms like itching, redness, and mucous discharge. Option A) contact allergy is incorrect because it refers to an allergic reaction to the material of the contact lens itself, not specifically related to wearing contact lenses. Option B) allergic conjunctivitis is incorrect as it is a general term for inflammation of the conjunctiva due to allergens, not directly linked to contact lens wear. Option C) vernal keratoconjunctivitis is incorrect as it is a seasonal allergic condition affecting the conjunctiva and cornea, typically seen in children and young adults, and is not directly caused by contact lenses. In pediatric nursing practice, understanding the complications associated with contact lens wear is crucial to providing comprehensive care to children who use them. Educating parents and children about proper contact lens hygiene, regular follow-ups with eye care providers, and recognizing signs of complications like giant papillary conjunctivitis are essential components of pediatric eye care education.

Correct Answer: A

Rationale: In fatal anaphylaxis, one of the principal pathologic features is acute bronchial obstruction, making option A the correct answer. This is because anaphylaxis is a severe, life-threatening allergic reaction that can cause the airways to narrow rapidly, leading to breathing difficulties and potentially fatal consequences. Acute bronchial obstruction can result in respiratory distress and, if not promptly treated, can lead to respiratory failure and death. Option B, hypotension, is a common feature of anaphylaxis but is not the principal pathologic feature in fatal cases. While hypotension can occur due to systemic vasodilation and fluid shifts, it is the acute bronchial obstruction that is more directly associated with fatal outcomes in anaphylaxis. Options C and D, behavioral change and abdominal pain, are not primary pathologic features of fatal anaphylaxis. Behavioral changes may occur due to hypoxia resulting from bronchial obstruction, but they are not the principal feature. Abdominal pain is typically associated with conditions like abdominal emergencies or gastrointestinal issues, not with fatal anaphylaxis. In an educational context, understanding the key pathologic features of fatal anaphylaxis is crucial for healthcare providers, especially those working with pediatric patients who may be more vulnerable to severe allergic reactions. Recognizing and promptly addressing acute bronchial obstruction can be life-saving in managing anaphylactic reactions in children. Training in recognizing the signs and symptoms of anaphylaxis and knowing the appropriate interventions is essential for nurses and other healthcare professionals caring for pediatric patients.

Correct Answer: C

Rationale: In this question about acute IgE-mediated food allergy symptoms, the correct answer is C) abdominal pain. Acute IgE-mediated food allergies typically present with symptoms like urticaria (hives), pruritis (itching), and diarrhea due to the body's immune response to the allergen. Abdominal pain is not a classic symptom of this type of allergy reaction. Urticaria and pruritis are common skin manifestations of an allergic reaction, while diarrhea can occur due to gastrointestinal involvement. Abdominal pain is more commonly associated with non-IgE-mediated food allergies or other gastrointestinal conditions rather than the immediate hypersensitivity reaction seen in IgE-mediated allergies. Educationally, understanding the specific symptoms associated with different types of food allergies is crucial for healthcare professionals working with pediatric patients. Recognizing these symptoms accurately can lead to timely diagnosis and management of allergic reactions, which is essential in preventing severe outcomes in children with food allergies. This knowledge helps in providing safe and effective care for pediatric patients with allergies.