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 the appearance of hives or welts in response to pressure or friction on the skin. This condition is often referred to as "skin writing" due to its unique presentation. Cholinergic urticaria (B) is triggered by sweating, cold urticaria (C) by exposure to cold temperatures, and delayed pressure urticaria (D) by sustained pressure on the skin. While these are all types of physical urticaria, they are less common compared to dermatographism. In an educational context, understanding different types of urticaria is crucial for pediatric nurses as they care for children with skin conditions. Recognizing dermatographism as the most common physical urticaria allows nurses to provide appropriate care and education to patients and their families. It also helps in differentiating between various types of urticaria to ensure accurate assessment and treatment interventions.

Correct Answer: A

Rationale: In congestive heart failure (CHF), the primary aim of ACE inhibitors is to improve afterload. Afterload refers to the pressure that the heart must work against to eject blood during systole. By dilating blood vessels, ACE inhibitors reduce systemic vascular resistance, thereby decreasing afterload. This reduction in afterload eases the workload on the heart, allowing it to pump more efficiently and effectively in CHF patients. Option B, contractility, is not the primary aim of ACE inhibitors in CHF treatment. While ACE inhibitors can have a mild positive inotropic effect (increasing contractility), their main benefit lies in reducing afterload. Option C, heart rate, is not a direct target of ACE inhibitors in CHF treatment. ACE inhibitors do not have a significant impact on heart rate. Option D, myocardial relaxation, is also not the primary focus of ACE inhibitors in CHF. While ACE inhibitors may have some impact on myocardial relaxation, their main mechanism of action in CHF is through afterload reduction. In an educational context, understanding the specific goals of medications like ACE inhibitors in CHF treatment is crucial for nurses caring for pediatric patients with heart failure. By comprehending the rationale behind medication therapies, nurses can provide more effective and individualized care, monitor for appropriate outcomes, and educate patients and families on the importance of medication adherence in managing CHF.

Correct Answer: D

Rationale: In this scenario, the most likely diagnosis for a 5-day-old infant presenting with severe heart failure, poor perfusion, and a gallop rhythm is option D) Hypoplastic left heart. Hypoplastic left heart syndrome is a critical congenital heart defect where the left side of the heart is underdeveloped, resulting in inadequate blood flow to the body. Infants with this condition typically present with signs of heart failure early in life due to the inability of the heart to effectively pump blood to meet the body's needs. Option A) Arteriovenous malformation is a vascular disorder, not a congenital heart defect, and would not present with the specific cardiac symptoms described. Option B) Atrioventricular septal defect is a type of congenital heart defect but typically presents with different symptoms such as a holosystolic murmur and signs of heart failure that are different from those described in the case. Option C) Coarctation of the aorta is a narrowing of the aorta, which can lead to high blood pressure and differences in blood pressure between the upper and lower extremities. While it can present with poor perfusion, it does not typically present with the severe heart failure and gallop rhythm described in the case. Educationally, understanding the different presentations of congenital heart defects in infants is crucial for pediatric nurses. Recognizing the specific signs and symptoms of each condition allows for timely intervention and appropriate management to improve patient outcomes. In this case, identifying the critical nature of hypoplastic left heart syndrome and initiating prompt treatment is essential for the infant's well-being.

Correct Answer: B

Rationale: The correct answer is B) immediate return to your office or the nearest emergency room. In the case of an 8-year-old boy with acute streptococcal tonsillitis who experiences a reaction shortly after taking penicillin, there is a concern for a potential severe allergic reaction or anaphylaxis. An immediate return to a healthcare facility is crucial for prompt evaluation and management to prevent any life-threatening complications. Option A) oral Benadryl and call again if not improved within 30 minutes is incorrect because in a suspected severe allergic reaction, delaying treatment with oral Benadryl at home is not safe or recommended. Immediate medical attention is needed. Option C) return to your office or the nearest emergency room if he becomes short of breath or loses consciousness is partially correct in emphasizing the need for urgent care in case of respiratory distress or loss of consciousness. However, waiting for these severe symptoms to occur before seeking help can be dangerous. Option D) that they go to the laboratory for determination of serum tryptase level is incorrect as it is not the immediate priority in this situation. Assessing serum tryptase levels is typically done later in the evaluation of an allergic reaction but is not the first step in managing a suspected anaphylactic reaction. In an educational context, this question highlights the importance of recognizing and responding to potential allergic reactions in pediatric patients. It underscores the critical need for healthcare providers to act swiftly when faced with a situation that could escalate into a life-threatening emergency. By understanding the urgency of the situation and the appropriate course of action, healthcare professionals can ensure the safety and well-being of their young patients.

Correct Answer: D

Rationale: Cromolyn is a medication used in the management of asthma, allergic rhinitis, and other allergic conditions. The correct answer, option D, states that all the statements are true. Let's break down each option to understand why the correct answer is right and why the others are incorrect: A) It prevents antibody-mediated mast cell degranulation: This statement is true. Cromolyn works by stabilizing mast cells, preventing the release of inflammatory mediators like histamine in response to allergens. This action helps in reducing allergic symptoms. B) It prevents non-antibody-mediated mast cell degranulation: This statement is also true. Cromolyn not only inhibits the release of mediators triggered by antibodies but also those induced by non-antibody mechanisms, providing a broad anti-inflammatory effect. C) It has no bronchodilator properties: This statement is false. Cromolyn is not a bronchodilator. Instead, it helps in preventing asthma attacks by reducing the release of inflammatory substances, but it does not directly dilate the airways like bronchodilators such as albuterol. In an educational context, understanding the mechanisms of action of medications like cromolyn is crucial for pediatric nurses caring for children with asthma and allergies. By grasping how cromolyn works to prevent mast cell degranulation, nurses can better educate patients and families on the proper use of the medication and its role in managing these conditions effectively. This knowledge also aids in assessing treatment effectiveness and potential side effects, contributing to improved patient outcomes.