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: 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: C

Rationale: In the context of pediatric nursing, understanding the causes of angioedema without urticaria is crucial for providing safe and effective care to pediatric patients. In this scenario, the correct answer is C) Foods. Angioedema without urticaria can be caused by various factors, including allergic reactions to certain foods such as nuts, shellfish, or fruits. ACE inhibitors (Option A) are a common cause of angioedema with urticaria, making this option incorrect in the context of the question. Hereditary angioedema (Option B) is a genetic condition that can cause recurrent episodes of angioedema with or without urticaria, so it is not the correct answer in this case. Insect stings (Option D) can also trigger angioedema with urticaria, but in the absence of urticaria, this is not a common cause of angioedema. Educationally, understanding the different etiologies of angioedema is essential for pediatric nurses to accurately assess, diagnose, and manage pediatric patients presenting with these symptoms. Recognizing the specific triggers for angioedema without urticaria can lead to appropriate interventions, such as avoiding specific foods or allergens, administering antihistamines, or providing emergency care in severe cases. This knowledge empowers pediatric nurses to deliver high-quality care and ensure positive patient outcomes in cases of angioedema without urticaria.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding drug-induced anaphylaxis and its common causes is crucial for providing safe and effective care to pediatric patients. The correct answer, B) Aspirin, is not a common cause of drug-induced anaphylaxis in comparison to the other options provided. Aspirin is more commonly associated with non-allergic reactions such as gastrointestinal issues or asthma exacerbation in patients with underlying respiratory conditions like asthma. Penicillin (Option A), NSAIDs (Option C), and radiocontrast media (Option D) are known to be more frequent culprits in drug-induced anaphylaxis in pediatric patients. Penicillin is one of the most common causes of drug allergies in general, including anaphylaxis. NSAIDs, especially in patients with asthma or chronic urticaria, can trigger severe allergic reactions. Radiocontrast media can also induce anaphylaxis, particularly in patients with a history of reactions to contrast agents. In an educational context, this question serves to assess the test-taker's knowledge of common triggers of drug-induced anaphylaxis in pediatric patients. Understanding these common causes is essential for nurses to promptly recognize and manage allergic reactions in pediatric patients, ensuring their safety and well-being.

Correct Answer: B

Rationale: The correct answer is B) Two major manifestations and one minor manifestation. In the case of Ahmed, he presents with migratory polyarthritis (a major manifestation), newly heard apical pansystolic murmur (a major manifestation), and positive acute phase reactants (a minor manifestation). This combination fulfills the Jones criteria for the diagnosis of rheumatic fever. Option A is incorrect as it suggests two major and two minor manifestations, which does not align with Ahmed's presentation. Option C is incorrect as it suggests one major and two minor manifestations, which is not consistent with the criteria for diagnosing rheumatic fever. Option D is incorrect as it implies only two major manifestations without considering the minor manifestations required for a definitive diagnosis. In an educational context, understanding the criteria for diagnosing rheumatic fever is crucial for pediatric nurses to accurately assess and manage patients. By recognizing the importance of major and minor manifestations, nurses can provide timely and appropriate care for children like Ahmed who are at risk for developing complications associated with rheumatic fever.

Correct Answer: D

Rationale: Functional abdominal pain is a common complaint in pediatric patients, and recognizing its features is crucial for effective nursing care. The correct answer is D) Recurrent periumbilical pain. This symptom is characteristic of functional abdominal pain and is often described as a central, intermittent pain around the umbilicus. Children with functional abdominal pain typically have normal growth patterns and no alarming symptoms like weight loss or vomiting blood, making deceleration of linear growth (B) and dysphagia (A) less likely. Nocturnal diarrhea (C) is not a typical feature of functional abdominal pain and may suggest other gastrointestinal issues. Educationally, understanding the distinguishing features of functional abdominal pain helps pediatric nurses provide appropriate care, alleviate patient anxiety, and educate families on managing the condition. By knowing the correct symptoms, nurses can guide treatment strategies, such as reassurance, dietary modifications, and stress management techniques, to improve the child's quality of life. Recognizing and differentiating these symptoms also prevent unnecessary tests and treatments, promoting cost-effective and patient-centered care.