The MOST common physical urticaria is

Correct Answer: A

Rationale: The correct answer is A) dermatographism. Dermatographism is the most common physical urticaria, characterized by raised, red, itchy welts that appear after firmly stroking or scratching the skin. This condition is known for its distinct response to physical stimuli like pressure or friction. Option B) cholinergic urticaria is triggered by sweating or an increase in body temperature, not by physical pressure or stimulus like dermatographism. Option C) cold urticaria is triggered by exposure to cold temperatures, not by physical stimuli. Option D) delayed pressure urticaria presents as red welts after pressure is applied to the skin for a period of time, but it is less common than dermatographism. Educationally, understanding the different types of physical urticaria is crucial for healthcare professionals, especially pediatric nurses, who may encounter children with skin conditions. Recognizing dermatographism as the most common type helps in accurate diagnosis and appropriate treatment, ensuring optimal care for pediatric patients with this condition. Being able to differentiate between various types of urticaria enhances clinical assessment skills and improves patient outcomes.

Correct Answer: A

Rationale: The correct answer is option A) Afterload. In congestive heart failure (CHF), the primary aim of ACE inhibitors is to reduce the afterload, which is the resistance that the heart must overcome to eject blood out into the systemic circulation. By reducing afterload, ACE inhibitors help the heart pump more efficiently, decrease the workload on the heart, and improve cardiac output. Option B) Contractility is incorrect because ACE inhibitors do not directly impact the contractility of the heart muscle. They primarily work by dilating blood vessels and reducing afterload. Option C) Heart rate is incorrect because ACE inhibitors do not directly influence heart rate. Their main mechanism of action is not related to altering the heart rate. Option D) Myocardial relaxation is incorrect because while ACE inhibitors may have some indirect effect on myocardial relaxation through their actions on afterload, it is not their primary aim in the treatment of CHF. In an educational context, understanding the specific goals of medications used in managing pediatric patients with CHF is crucial for pediatric nurses. Knowing how ACE inhibitors work and their intended physiological effects allows nurses to provide safe and effective care, monitor for therapeutic outcomes, and educate patients and families on the rationale behind their medication regimen.

Correct Answer: D

Rationale: The most likely diagnosis for a 5-day-old infant presenting with severe heart failure, poor perfusion, and a gallop rhythm is D) Hypoplastic left heart. **Explanation of the correct answer:** Hypoplastic left heart is a critical congenital heart defect where the left side of the heart is underdeveloped, leading to poor perfusion and heart failure. Infants with this condition typically present with severe symptoms early in life, necessitating prompt diagnosis and intervention. **Explanation of why others are wrong:** A) Arteriovenous malformation: This is a vascular abnormality, not a cardiac defect, and would not present with the characteristic symptoms described in the question. B) Atrioventricular septal defect: While this is a congenital heart defect, it typically presents differently than the symptoms described in the question. C) Coarctation of the aorta: This condition involves narrowing of the aorta, leading to high blood pressure in the upper body, which is not consistent with the symptoms described in the question. **Educational context:** Understanding congenital heart defects is crucial for pediatric nurses as they play a key role in identifying early signs and symptoms, providing care, and supporting families. Hypoplastic left heart is a life-threatening condition that requires immediate medical intervention, making it essential for nurses to recognize its presentation and collaborate with the healthcare team for optimal patient outcomes. This question reinforces the importance of early recognition and appropriate management of critical congenital heart defects in infants.

Correct Answer: B

Rationale: Rationale: The correct answer is option B) immediate return to your office or the nearest emergency room. This is the best recommendation because acute streptococcal tonsillitis is a bacterial infection that can progress rapidly and cause complications such as difficulty breathing or even sepsis. Therefore, any adverse reaction to the penicillin V in this case requires immediate medical attention to ensure the safety and well-being of the child. Option A) recommending oral Benadryl and waiting 30 minutes is incorrect because in a potentially severe allergic reaction, delaying treatment can be dangerous and lead to worsening symptoms. Option C) is partially correct in mentioning shortness of breath or loss of consciousness as warning signs, but waiting for these symptoms to develop before seeking help is risky. Option D) is unrelated to the situation and not indicated for an allergic reaction to penicillin. Educationally, this question highlights the importance of prompt recognition and management of allergic reactions, especially in pediatric patients who may not be able to articulate their symptoms well. It underscores the need for healthcare providers to act swiftly and decisively in such situations to prevent serious outcomes.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the medication cromolyn is crucial for managing respiratory conditions in children, such as asthma. The correct answer, option D, "All of the above are true," is accurate because cromolyn functions by preventing both antibody-mediated and non-antibody-mediated mast cell degranulation. This action helps to inhibit the release of inflammatory mediators, thereby reducing bronchoconstriction and airway inflammation in conditions like asthma. Option A is incorrect because cromolyn does not specifically target only antibody-mediated mast cell degranulation; it also affects non-antibody-mediated degranulation. Option B is incorrect as cromolyn does not solely prevent non-antibody-mediated mast cell degranulation. Option C is also incorrect because while cromolyn is not a bronchodilator, it is effective in preventing asthma attacks by reducing inflammation and hypersensitivity in the airways. Educationally, it is essential for pediatric nurses to grasp the mechanism of action of medications like cromolyn to provide safe and effective care to pediatric patients with respiratory conditions. By understanding how cromolyn works, nurses can educate patients and families on its proper use, potential side effects, and the importance of adherence to the prescribed regimen for optimal management of respiratory symptoms in children.