The percentage of childhood asthma cases that persist into adulthood is approximately

Correct Answer: C

Rationale: In pediatric nursing, understanding the long-term outcomes of childhood illnesses like asthma is crucial for providing comprehensive care. The correct answer, option C) 30-50%, is supported by research and clinical observations. Asthma is a chronic condition that can persist into adulthood, affecting a significant percentage of individuals who had childhood asthma. This range accounts for the variability in individual cases and factors influencing disease progression. Option A) 5-10% is too low of an estimate. Asthma is known to often persist beyond childhood, with studies showing a higher prevalence in adult populations. Option B) 10-30% falls within a more plausible range but underestimates the persistence of childhood asthma into adulthood. Option D) 50-70% is too high and would imply that the majority of childhood asthma cases continue into adulthood, which is not supported by current data. Educationally, this question highlights the importance of understanding the natural history of pediatric conditions and their implications for long-term patient management. Nurses need to be aware of the potential for childhood asthma to persist into adulthood to provide appropriate care, education, and support to both pediatric and adult patients with asthma. It underscores the need for continuous monitoring and proactive management strategies to improve outcomes for individuals with asthma across the lifespan.

Correct Answer: B

Rationale: In atopic dermatitis, the presence of punched-out erosions, vesicles, and infected skin lesions that do not respond to oral antibiotics suggests an infection with Herpes simplex. Herpes simplex virus can cause a severe infection in patients with compromised skin integrity due to atopic dermatitis. The virus can lead to painful vesicles and erosions that are often difficult to manage with conventional antibiotics. Option A) Herpes zoster typically presents as a painful rash in a dermatomal distribution and is not commonly associated with atopic dermatitis. Option C) Cutaneous warts are caused by human papillomavirus and present as raised, rough growths on the skin, not as punched-out erosions or vesicles. Option D) Trichophyton rubrum is a fungus responsible for causing dermatophytosis (ringworm) and does not typically present with the described features of punched-out erosions and vesicles in atopic dermatitis. In a pediatric nursing context, understanding the differential diagnosis of skin conditions is crucial for providing effective care to children. Recognizing the signs and symptoms of various infections helps nurses and healthcare providers make accurate diagnoses and implement appropriate treatment strategies promptly. This knowledge ensures optimal outcomes for pediatric patients with skin conditions such as atopic dermatitis.

Correct Answer: D

Rationale: In pediatric nursing, understanding indications for venom immunotherapy is crucial for safe and effective care. The correct answer, option D, is the systemic reaction with a positive skin test and negative in vitro test. This indicates a true systemic allergic reaction to a specific venom, warranting venom immunotherapy to desensitize the child to the allergen. Option A, a large local reaction with positive skin and in vitro tests, typically does not warrant venom immunotherapy as it suggests a localized, rather than systemic, reaction. Option B, a generalized cutaneous reaction with a positive skin test and negative in vitro test, also does not meet the criteria for venom immunotherapy as it lacks a systemic component. Option C, a generalized cutaneous reaction with a positive in vitro test and negative skin test, is not indicative of venom immunotherapy as a positive skin test is typically required for diagnosis. Educationally, understanding the nuances of allergic reactions and the specific criteria for venom immunotherapy in pediatric patients ensures accurate assessment and appropriate treatment. Recognizing the combination of systemic symptoms and specific test results is essential for providing optimal care to children with venom allergies.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding the etiology of chronic urticaria is crucial for providing effective care to children. The correct answer is B) systemic lupus erythematosus. Chronic urticaria is a condition characterized by persistent hives lasting more than 6 weeks. In children, systemic lupus erythematosus, an autoimmune disease, can manifest with chronic urticaria as a skin manifestation. This association underscores the importance of considering underlying systemic conditions in the differential diagnosis of chronic urticaria in pediatric patients. Option A) latex is incorrect because while latex allergy can cause acute urticaria, it is less commonly associated with chronic urticaria. Option C) IV immunoglobulin is incorrect as it is often used in the treatment of some autoimmune conditions but is not a common cause of chronic urticaria. Option D) streptococcal pharyngitis is incorrect as it is more likely to present with acute urticaria as a result of an infectious process rather than chronic urticaria. Educationally, understanding the various causes of chronic urticaria in pediatric patients is essential for nurses to provide comprehensive care. By grasping the link between systemic lupus erythematosus and chronic urticaria, nurses can advocate for timely assessments and interventions to address the underlying autoimmune process. This knowledge equips nurses with the ability to collaborate effectively with healthcare teams to ensure accurate diagnosis and management of pediatric patients presenting with chronic urticaria.

Correct Answer: D

Rationale: The correct answer is D) plasma tryptase. Plasma tryptase is the best diagnostic test for anaphylaxis in a child due to its specificity and sensitivity in detecting mast cell activation, which is a key feature of anaphylaxis. Tryptase levels rise early during an anaphylactic reaction and can remain elevated for several hours, making it a reliable marker to confirm the diagnosis. Option A) plasma histamine is not as specific for anaphylaxis as tryptase. Histamine levels can be affected by various factors and may not always correlate with the severity of an allergic reaction. Option B) skin tests are used to identify specific allergens triggering allergic reactions, but they are not diagnostic for anaphylaxis itself. Option C) radioallergosorbent assay (RAST) is a blood test that measures the amount of specific IgE antibodies to particular allergens. While useful for identifying triggers for allergic reactions, it is not specific for diagnosing anaphylaxis. In an educational context, understanding the most appropriate diagnostic tests for anaphylaxis is crucial for pediatric nurses to provide prompt and accurate care to children experiencing severe allergic reactions. Knowledge of specific markers like plasma tryptase can guide clinical decision-making and help in initiating timely interventions to manage anaphylaxis effectively.