The mother of an 8-year-old boy with acute streptococcal tonsillitis calls to report that within 15 minutes after the first dose of penicillin V... You should recommend

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: C

Rationale: Angioedema without urticaria is characterized by localized swelling without the presence of hives. In this context, foods are not a common cause of angioedema without urticaria. Angioedema without urticaria is often associated with ACE inhibitors, hereditary angioedema, and insect stings. The correct answer, option C, foods, is not a common cause of angioedema without urticaria. While certain foods can trigger allergic reactions leading to angioedema with urticaria, they are not typically associated with angioedema without urticaria. Option A, ACE inhibitors, are a common cause of angioedema without urticaria due to drug-induced mechanisms. Option B, hereditary angioedema, is a genetic condition that can lead to recurrent episodes of angioedema. Option D, insect stings, can also trigger angioedema without urticaria in individuals with insect sting allergies. In a pediatric nursing context, understanding the different etiologies of angioedema is crucial for accurate diagnosis and appropriate management. Educating healthcare providers about the various triggers of angioedema can help improve patient outcomes by facilitating timely recognition and intervention.

Correct Answer: B

Rationale: In the context of pediatric nursing, it is crucial to understand the common causes of drug-induced anaphylaxis to ensure prompt recognition and appropriate management. In this question, the correct answer is B) Aspirin. Aspirin is not a common cause of drug-induced anaphylaxis in comparison to the other options provided. Penicillin (Option A) is a well-known common cause of drug-induced anaphylaxis. NSAIDs (Option C) like ibuprofen and naproxen are also frequently associated with allergic reactions, including anaphylaxis. Radiocontrast media (Option D) can trigger allergic reactions, including anaphylaxis, in some individuals, especially those with a history of sensitivity to these substances. Educationally, understanding the varying degrees of allergenic potential among different drugs is essential in pediatric nursing practice. Nurses need to be able to differentiate between common and uncommon triggers of anaphylaxis to provide safe and effective care to pediatric patients. Additionally, knowledge of potential allergens helps in preventing adverse reactions and in educating patients and their families about medication safety.

Correct Answer: B

Rationale: The correct answer is B) Two major manifestations and one minor manifestation. In diagnosing rheumatic fever, the Jones criteria are used. Major manifestations include carditis (e.g., pansystolic murmur), polyarthritis, chorea, erythema marginatum, and subcutaneous nodules. Minor manifestations include arthralgia, fever, elevated acute phase reactants (like ASOT), prolonged PR interval on ECG. In this case, Ahmed has migratory polyarthritis, a major manifestation. The newly heard apical pansystolic murmur is also a major manifestation. The positive acute phase reactants and ASOT of 500 units are minor manifestations. Therefore, the correct answer is B. Option A is incorrect as it includes two minor manifestations instead of one. Option C is incorrect as it has one major and two minor manifestations. Option D is incorrect as it does not include any minor manifestations. Understanding the Jones criteria is crucial for healthcare providers, especially pediatric nurses, as it helps in the accurate diagnosis of rheumatic fever in children. Recognizing the major and minor manifestations aids in prompt treatment and prevention of complications associated with rheumatic fever.

Correct Answer: D

Rationale: Functional abdominal pain is a common condition in children and adolescents. The correct answer is D) Recurrent periumbilical pain. This is because functional abdominal pain is characterized by recurrent abdominal pain that is not associated with organic or structural abnormalities. Periumbilical pain is a common presentation of functional abdominal pain in pediatric patients. Option A) Dysphagia is difficulty swallowing, which is not typically associated with functional abdominal pain but rather with upper gastrointestinal issues. Option B) Deceleration of linear growth is more indicative of chronic conditions such as malnutrition or endocrine disorders, rather than functional abdominal pain. Option C) Nocturnal diarrhea is more commonly seen in conditions like inflammatory bowel disease or infections, rather than functional abdominal pain. Educationally, understanding the features of functional abdominal pain is crucial for healthcare providers who care for pediatric patients. Recognizing the distinguishing characteristics helps in making an accurate diagnosis and providing appropriate treatment, which may include reassurance, lifestyle modifications, and possibly behavioral therapies. It is important to differentiate functional abdominal pain from organic causes to prevent unnecessary tests and interventions, and to address the patient's symptoms effectively.