The percentage of allergic rhinitis in asthmatic patients is 78%, while the percentage of asthma in patients with allergic rhinitis is

Correct Answer: D

Rationale: In this question, the correct answer is D) 48%. The percentage of asthma in patients with allergic rhinitis is 48% because the question states that the percentage of allergic rhinitis in asthmatic patients is 78%. This implies that among asthmatic patients, 78% also have allergic rhinitis, leaving 22% with asthma but without allergic rhinitis. Therefore, among patients with allergic rhinitis, the remaining 22% have asthma, giving us a total of 78% + 22% = 100% of asthmatic patients. Now, let's analyze why the other options are incorrect: A) 18%: This percentage does not align with the information provided in the question and is not a logical deduction based on the given data. B) 28%: Similarly, this percentage does not match with the information provided and does not follow logically from the given data. C) 38%: This option is also incorrect as it does not reflect the relationship between allergic rhinitis and asthma as stated in the question stem. Educationally, this question helps reinforce the understanding of the co-existence of allergic rhinitis and asthma in patients. Understanding the comorbidity between these conditions is crucial for healthcare professionals, especially in the pediatric population where these conditions are common. By grasping the epidemiological aspects of these conditions, nurses can provide better care, anticipate complications, and implement appropriate management strategies for pediatric patients with allergic rhinitis and asthma.

Correct Answer: D

Rationale: In pediatric nursing, understanding the features of well-controlled asthma is crucial for effective management. In the case of a 7-year-old boy, the correct answer is D) 2-4 exacerbations in the past year. This is because having 2-4 exacerbations indicates poorly controlled asthma, not well-controlled asthma. A) FEV1/FVC ratio >80% and B) FEV1 >80% of predicted are indicative of good lung function, which are features of well-controlled asthma. C) Daytime symptoms ≤2 days/week suggest good symptom control, also characteristic of well-controlled asthma. Educationally, knowing these features helps nurses assess and monitor asthma control in pediatric patients. Recognizing well-controlled asthma allows for appropriate adjustments in medication and management plans to maintain optimal health and quality of life for the child. Understanding these distinctions ensures that healthcare providers can provide the best care and support for pediatric patients with asthma.

Correct Answer: A

Rationale: Atopic dermatitis (AD) is a common chronic inflammatory skin condition that predominantly affects children. The major clinical features of AD include a family history of atopic conditions, such as asthma or allergic rhinitis, relapsing dermatitis characterized by periods of exacerbation and remission, and facial eczema commonly seen in infants due to their more sensitive skin. The correct answer, option A, "extensor eczema in adolescents," is incorrect because extensor involvement is a typical feature of childhood AD, not limited to adolescents. Option B, "family history," is a characteristic feature of AD as there is a strong genetic predisposition to atopic conditions. Option C, "relapsing dermatitis," is also a classic feature of AD, with periods of flares and remissions. Option D, "facial eczema in infants," is another common presentation of AD due to the delicate and sensitive nature of infant skin. Educationally, understanding the clinical features of AD is crucial for healthcare professionals, especially pediatric nurses, as they play a vital role in the assessment, management, and education of patients and families affected by AD. Recognizing these features helps in accurate diagnosis, appropriate treatment planning, and providing comprehensive support to improve the quality of life for children with AD and their families.

Correct Answer: C

Rationale: In the treatment of atopic dermatitis, it is crucial to monitor the response to medications to ensure optimal outcomes for pediatric patients. Omalizumab, as the correct answer, is a monoclonal antibody that targets immunoglobulin E (IgE) and is typically used for severe cases of atopic dermatitis. If a pediatric patient fails to show improvement within 4-6 weeks of starting omalizumab, it should be discontinued as it may indicate inefficacy or the need to explore alternative treatment options. Regarding the incorrect options: - A) Methotrexate is a medication used in severe cases of atopic dermatitis, but discontinuation is not solely based on a lack of response within a specific timeframe. - B) Azathioprine is an immunosuppressant that may take longer to show results, and discontinuation should be guided by the healthcare provider's assessment of the patient's response. - D) Mycophenolate mofetil is another immunosuppressant that may require a longer duration to evaluate its effectiveness in managing atopic dermatitis. In an educational context, understanding the rationale behind discontinuing medications in the treatment of atopic dermatitis is essential for pediatric nurses to provide safe and effective care. Monitoring the response to treatment, knowing when to discontinue a medication, and collaborating with the healthcare team for alternative options are critical aspects of pediatric nursing practice. This knowledge ensures that pediatric patients receive appropriate and timely interventions to manage their atopic dermatitis effectively.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding the diagnostic approach to severe systemic reactions is crucial for providing safe and effective care to children. In this scenario, the correct next diagnostic step for patients with initially negative skin tests but a convincing history of a severe systemic reaction is to repeat the skin test after 4-6 weeks (Option B). The rationale behind choosing to repeat the skin test is based on the principle of delayed hypersensitivity reactions. It takes time for the body to sensitively react to an allergen, so a negative result immediately after an exposure does not rule out an allergy. Repeating the skin test after a few weeks allows for the development of a detectable immune response. Option A, in vitro serum assay for venom-specific IgE, may not be as sensitive as a repeat skin test for detecting an IgE-mediated allergic reaction. Option C, serum tryptase level, and Option D, plasma histamine, are not typically used as initial diagnostic tests for confirming an allergic reaction to a specific allergen. Educationally, this question highlights the importance of understanding the limitations of initial diagnostic tests and the value of timing in evaluating allergic reactions in pediatric patients. It underscores the need for thorough assessment, critical thinking, and evidence-based practice in pediatric nursing to ensure accurate diagnosis and appropriate management of allergic conditions.