The standard method for diagnosing food allergy, used to determine whether a child can eat a food safely, is

Correct Answer: A

Rationale: The correct answer is A) oral food challenges. This method is considered the gold standard for diagnosing food allergies because it involves directly exposing the individual to the suspected food under controlled conditions to observe any allergic reactions. This helps healthcare providers determine with certainty whether a child can safely consume a particular food. Option B) serum specific IgE assay measures the levels of specific antibodies in the blood, which can indicate sensitization to a particular allergen. While this test is useful for screening and identifying potential allergens, it alone cannot confirm a clinical food allergy diagnosis. Option C) prick skin test involves introducing a small amount of the suspected allergen under the skin to observe for a local allergic reaction. While this test is helpful in identifying potential allergens, it may not always correlate with actual clinical food allergies and should be used in conjunction with other diagnostic methods. Option D) patch testing is typically used to diagnose contact dermatitis and is not generally used for diagnosing food allergies. It involves applying small amounts of suspected allergens to the skin to detect delayed hypersensitivity reactions, which are different from immediate food allergies. In an educational context, it is essential for healthcare providers, especially pediatric nurses, to understand the different diagnostic methods for food allergies to provide accurate and appropriate care to children with suspected food allergies. By knowing the limitations and strengths of each diagnostic test, nurses can work collaboratively with other healthcare professionals to ensure accurate diagnosis and management of food allergies in pediatric patients.

Correct Answer: D

Rationale: The most appropriate therapy to maximize urinary excretion of aspirin in a 4-year-old boy who has ingested a large dose is urinary alkalinization, which is option D. Rationale: 1. **Correct Answer (D - Urinary alkalinization):** Aspirin is a weak acid that is excreted more rapidly in alkaline urine. Urinary alkalinization involves administering sodium bicarbonate or acetazolamide to raise the pH of the urine, which enhances the excretion of aspirin and reduces its toxicity. 2. **Why Others are Wrong:** - A) Allopurinol: Allopurinol is used to treat gout by reducing uric acid levels and would not enhance the excretion of aspirin. - B) Forced diuresis with furosemide: While increasing urine output can help eliminate toxins, forced diuresis is not specific for enhancing aspirin excretion. - C) Hyperhydration: While hydration is important in managing aspirin toxicity, it alone does not maximize urinary excretion of aspirin. 3. **Educational Context:** Understanding the principles of pharmacokinetics and how different substances are excreted from the body is crucial in pediatric nursing. In cases of aspirin toxicity, knowing the appropriate interventions to enhance elimination can be life-saving. Teaching students to consider factors like pH and drug properties when selecting therapies is essential for safe and effective pediatric care.

Correct Answer: A

Rationale: In this scenario, the most likely diagnosis for a patient presenting with headache, poor nasal airflow two weeks after initial symptoms is sinusitis (Option A). Sinusitis is characterized by inflammation of the paranasal sinuses, leading to symptoms like headache, nasal congestion, and facial pain. In the context of a pediatric patient with worsening symptoms after an initial upper respiratory infection, sinusitis is a common sequelae. Option B, foreign body, is less likely in this case as the symptoms described are more indicative of an inflammatory process rather than a persistent foreign object obstructing the nasal passage. Rhinitis medicamentosa (Option C) is associated with nasal decongestant overuse and typically presents with rebound nasal congestion, not necessarily headache. Choanal stenosis (Option D) is a congenital condition characterized by narrowing of the back of the nasal passage, usually presenting earlier in infancy rather than two weeks after initial symptoms. Educationally, understanding the progression of upper respiratory symptoms in pediatric patients is crucial for nursing practice. Recognizing the signs and symptoms of sinusitis, differentiating them from other conditions like foreign bodies or medication-induced rhinitis, and considering the timeline of symptom onset are all essential skills for pediatric nurses to provide timely and appropriate care for their patients.

Correct Answer: D

Rationale: In the context of pediatric nursing and allergy testing, the correct answer is D) Skin testing is less expensive than RAST. This is because skin testing is a cost-effective method for determining specific IgE levels in comparison to the Radioallergosorbent Test (RAST). Skin testing involves applying allergen extracts to the skin and observing for a local allergic reaction, which is a relatively simple and inexpensive procedure. Option A, stating that "Skin testing is not affected by administration of antihistamines," is incorrect because antihistamines can interfere with the accuracy of skin testing results by suppressing the histamine response on the skin. Option B, claiming that "Skin testing has greater sensitivity than RAST," is incorrect as both skin testing and RAST have their own levels of sensitivity depending on the specific allergen being tested. Option C, mentioning that "Skin testing is semiquantitative," is not the best advantage to highlight when comparing skin testing with RAST. While skin testing may provide some level of quantitative information based on the size of the reaction, it is not as precise or standardized as RAST in providing specific IgE levels. In the educational context, it is important for pediatric nurses to understand the advantages and limitations of different allergy testing methods to provide accurate and efficient care for pediatric patients with allergies. By knowing that skin testing is a cost-effective option, nurses can advocate for this method when appropriate, considering factors such as cost, patient comfort, and reliability of results.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) None of the above. This option is the most appropriate because the patient presents with acute urticaria, which is typically a self-limiting condition in pediatric patients. The symptoms have been present for 10 days, and given the acute onset and short duration, extensive diagnostic testing may not be necessary at this point. Option A) Systematic elimination diets to determine a possible ingestant cause is not recommended as the first step in the evaluation of acute urticaria. Ingestant causes are less common in acute urticaria, and initiating elimination diets without proper evaluation can lead to unnecessary dietary restrictions and potential nutritional deficiencies. Option B) Allergy skin testing is also not recommended as the initial diagnostic option in this case. Allergy testing is more appropriate for chronic or recurrent cases of urticaria, and it is not typically indicated for acute presentations unless specific allergens are suspected based on history. Option C) Serum IgE and RAST testing may be helpful in specific cases of chronic urticaria where an allergic cause is suspected. However, in acute urticaria with a short duration like in this case, these tests are not typically necessary as they may not provide additional meaningful information for management. In an educational context, it is important for healthcare providers to understand the appropriate approach to the evaluation of acute urticaria in pediatric patients. Emphasis should be placed on taking a detailed history, including potential triggers, recent illnesses, and medication use, before considering extensive diagnostic testing. This case highlights the importance of a systematic and evidence-based approach to diagnosing and managing pediatric patients with acute skin conditions.