The MOST common cause of food protein-induced enteropathy is

Correct Answer: C

Rationale: The correct answer is C) cow's milk. Food protein-induced enteropathy is a condition characterized by inflammation and damage to the lining of the small intestine, leading to symptoms like diarrhea, malabsorption, and failure to thrive in infants and young children. Cow's milk is the most common cause of this condition due to the immaturity of the infant's digestive system, making it difficult to digest the proteins found in cow's milk. Option A) peanuts and Option D) eggs are common allergenic foods in children, but they are not typically associated with food protein-induced enteropathy. Option B) fish is also a common allergen but is less likely to cause enteropathy compared to cow's milk in young children. In an educational context, understanding the common causes of food protein-induced enteropathy is crucial for healthcare providers working with pediatric patients. Recognizing the signs and symptoms, as well as the most likely culprits, can lead to timely diagnosis and appropriate management to improve the child's health outcomes. It also highlights the importance of thorough dietary history and allergen testing in pediatric patients presenting with gastrointestinal issues.

Correct Answer: A

Rationale: In vivo skin testing for allergen-specific IgE involves introducing a small amount of allergen into the skin to observe the body's reaction. The wheal and flare reaction is a classic response seen in allergic individuals. The correct answer, option A) 15 to 20 minutes, is right because this is the typical timeframe within which the wheal and flare reaction is measured after the allergen is introduced into the skin. This immediate reaction helps in diagnosing allergies quickly and accurately. Option B) 30 to 60 minutes is incorrect because waiting this long would not capture the immediate response indicative of an IgE-mediated allergic reaction. Option C) 12 to 24 hours and D) 24 to 48 hours are also incorrect as they are too delayed to be associated with the wheal and flare reaction seen in skin testing for allergen-specific IgE. In an educational context, understanding the timing of the wheal and flare reaction in skin testing is crucial for pediatric clinical nurse specialists. It helps in accurately diagnosing allergies in children, guiding treatment plans, and providing appropriate patient education regarding allergen avoidance and management. Recognizing the immediate nature of this reaction is essential for providing timely and effective care to pediatric patients with allergies.

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 is based on the guidelines for managing asthma in children, where persistent wheezing indicates the need for long-term control therapy to prevent exacerbations and maintain optimal lung function. Option A) two or more episodes of wheezing is incorrect because the guideline specifies three or more episodes as the threshold for initiating daily long-term control therapy. Option C) four or more episodes and Option D) five or more episodes exceed the recommended threshold and would lead to unnecessary treatment in children who do not meet the criteria for daily therapy. Educationally, it is important for pediatric clinical nurse specialists to understand the criteria for initiating long-term control therapy in young children with asthma to provide appropriate and evidence-based care. Recognizing the appropriate indications for treatment can help prevent unnecessary medication use and improve outcomes for pediatric patients with asthma.

Correct Answer: C

Rationale: In the context of pediatric care, it is crucial to understand the appropriate management of common conditions like nasal congestion due to rhinitis. The correct answer is C) pseudoephedrine. Pseudoephedrine is a decongestant that works by narrowing the blood vessels in the nasal passages, leading to reduced swelling and congestion. It is effective in relieving nasal congestion associated with rhinitis by improving airflow and reducing symptoms. Option A) diphenhydramine and Option B) hydroxyzine are both antihistamines that are more effective for relieving symptoms like itching, sneezing, and watery eyes that are caused by allergies. They are not as effective in treating nasal congestion as decongestants like pseudoephedrine. Option D) cetirizine is a second-generation antihistamine that is also more effective in treating allergy symptoms rather than nasal congestion specifically. Educationally, it is important for pediatric clinical nurse specialists to have a strong foundation in pharmacology and understand the mechanism of action of different medications to provide safe and effective care for pediatric patients with rhinitis and other respiratory conditions. Being able to differentiate between various medications and their appropriate uses is essential for optimizing patient outcomes.

Correct Answer: A

Rationale: In the management of urticaria and angioedema, avoidance of triggering agents is essential to prevent exacerbations. The mainstay of pharmacologic treatment for these conditions is second-generation H1 antihistamines, making option A the correct choice. Second-generation H1 antihistamines, such as loratadine, cetirizine, and fexofenadine, are preferred due to their decreased sedative effects compared to first-generation antihistamines. They work by blocking the action of histamine, which is responsible for the symptoms of urticaria and angioedema. Tricyclic antidepressants (option B) are not recommended as first-line treatment for urticaria and angioedema. They may be considered in some cases for their antihistaminic effects, but their side effect profile and potential for drug interactions make them less favorable. Corticosteroids (option C) are not typically used as the mainstay treatment for urticaria and angioedema due to their potential for long-term adverse effects and limited efficacy in these conditions. Leukotriene receptor blockers (option D) are more commonly used in conditions like asthma and allergic rhinitis, but they are not considered first-line treatment for urticaria and angioedema. In an educational context, understanding the appropriate pharmacologic management of urticaria and angioedema is crucial for pediatric clinical nurse specialists to provide optimal care to their patients. By recognizing the mainstay of treatment and the rationale behind it, nurses can effectively manage these conditions and improve patient outcomes.