The following is considered one of the B symptoms in Hodgkin disease:

Correct Answer: C

Rationale: The correct answer is C) Fever. In Hodgkin disease, B symptoms refer to systemic symptoms including fever, night sweats, and weight loss. These symptoms indicate a more advanced stage of the disease and are important for staging and treatment planning. Option A) Itching is not typically considered a B symptom in Hodgkin disease. Itching, or pruritus, can occur in some cases but is not a defining B symptom. Option B) Jaundice is not a B symptom in Hodgkin disease. Jaundice may indicate liver involvement or obstruction of the bile duct, but it is not a typical symptom of Hodgkin disease. Option D) Anemia is not a B symptom in Hodgkin disease. Anemia may occur as a result of bone marrow involvement by the disease, but it is not specific to B symptoms. Understanding the B symptoms in Hodgkin disease is crucial for pediatric clinical nurse specialists as they play a significant role in assessing disease progression and determining appropriate interventions. By recognizing these symptoms, healthcare providers can provide timely and effective care for pediatric patients with Hodgkin disease.

Correct Answer: B

Rationale: The Look-Listen-Feel procedure is a critical component of the primary assessment in pediatric emergency care. The correct answer, option B, "Assess for breathing," is crucial in evaluating a child's respiratory status. In pediatric patients, respiratory distress is a common emergency presentation, making the assessment of breathing a priority. Option A, "Assess for consciousness," is important in the primary assessment but is not the focus of the Look-Listen-Feel procedure. Consciousness is typically assessed using other methods such as the AVPU scale (Alert, Verbal, Pain, Unresponsive). Option C, "Assess for airway patency," is also essential in pediatric emergency care, but it is typically evaluated before the Look-Listen-Feel procedure. Ensuring a clear airway is a prerequisite for effective breathing assessment. Option D, "Assess for circulation," is vital in pediatric emergencies but is not the primary purpose of the Look-Listen-Feel procedure. Circulation is usually assessed through pulse checks and skin color, temperature, and capillary refill. Educationally, understanding the correct sequence and rationale behind the Look-Listen-Feel procedure equips pediatric nurses with the skills to prioritize and perform a systematic assessment in emergency situations. This knowledge is crucial for timely and accurate decision-making, ultimately leading to better outcomes for pediatric patients.

Correct Answer: D

Rationale: The correct answer is D) Post auricular lymphadenopathy. This finding is pathognomonic of rubella because it is a characteristic clinical sign associated specifically with rubella infection. Rubella typically presents with swollen lymph nodes behind the ear, known as post auricular lymphadenopathy, which is a key diagnostic feature of the disease. Option A) Severe prodromal stage is not pathognomonic of rubella as many viral illnesses can present with a severe prodromal stage. Option B) Circumoral pallor is not specific to rubella and can be seen in various other conditions such as anemia or shock. Option C) Maculopapular rash is a common manifestation in rubella, but it is not pathognomonic as it can also be seen in other viral infections like measles or roseola. Educationally, understanding the specific clinical signs associated with different pediatric illnesses is crucial for pediatric clinical nurse specialists. Recognizing pathognomonic signs like post auricular lymphadenopathy in rubella can help in accurate diagnosis and appropriate management of the condition, leading to improved patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) Net loss of water more than sodium. Rationale: Hypernatremic dehydration occurs when there is a deficit of water relative to sodium in the body, leading to elevated serum sodium levels. In this type of dehydration, more water is lost from the body than sodium, resulting in a relative excess of sodium. This imbalance causes water to move out of the cells into the extracellular space, leading to cellular dehydration. Explanation of why other options are incorrect: B) Marked loss of skin turgor while tongue is not dry: This statement describes characteristics of dehydration but does not specifically address hypernatremic dehydration. In hypernatremic dehydration, the focus is on the imbalance between water and sodium levels. C) Serum Na less than 135 mEq/L: This statement describes hyponatremia, which is the opposite of hypernatremia. In hypernatremic dehydration, serum sodium levels are elevated (>145 mEq/L). D) Low serum osmolality less than 275 mOsm/L: Hypernatremic dehydration is characterized by increased serum osmolality (>295 mOsm/L) due to the relative deficiency of water in relation to sodium. Educational context: Understanding the differences between various types of dehydration is crucial for healthcare professionals, especially pediatric clinical nurse specialists who care for vulnerable populations like children. Recognizing the specific characteristics of hypernatremic dehydration helps in accurate assessment, diagnosis, and management of pediatric patients with this condition. It is essential to differentiate hypernatremic dehydration from other types of dehydration to provide appropriate and timely interventions to prevent complications and promote optimal outcomes for pediatric patients.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Valvular pulmonary stenosis. A systolic ejection murmur at the upper left parasternal area associated with an ejection click is a classic finding in valvular pulmonary stenosis. The timing of the murmur coincides with the ejection of blood from the right ventricle through the stenotic pulmonary valve, leading to turbulent blood flow and the murmur sound. The ejection click is produced by the abrupt halt in the valve leaflets due to the stenosis. Option A) Aortic stenosis would present with a systolic ejection murmur best heard at the right upper sternal border and does not typically have an associated ejection click. Option C) Infundibular pulmonary stenosis would have a murmur best heard at the lower left sternal border. Option D) VSD would present with a holosystolic murmur at the left lower sternal border. Understanding these distinctions is crucial for pediatric clinical nurse specialists as they assess and diagnose pediatric patients with congenital heart defects. Recognizing the specific murmur characteristics associated with different conditions can guide further evaluation and management of the child's cardiac health. This knowledge helps in providing timely and appropriate care to pediatric patients with cardiovascular issues.