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

Correct Answer: A

Rationale: In pediatric nursing, diagnosing food allergies accurately is crucial to ensure the safety and well-being of children. The standard method for diagnosing food allergy is oral food challenges (Option A). This method involves administering increasing doses of the suspected food under controlled conditions to see if a reaction occurs. This is considered the gold standard as it provides the most definitive diagnosis of a food allergy. Serum specific IgE assay (Option B) measures the levels of specific IgE antibodies in the blood in response to a particular food. While this test can indicate sensitization to a food, it may not always correlate with clinical symptoms or accurately diagnose a true food allergy. Prick skin tests (Option C) involve placing a small amount of the food allergen on the skin and pricking the skin to see if a reaction occurs. While this test is useful for identifying potential allergens, it may produce false-positive results and cannot confirm a true food allergy on its own. Patch testing (Option D) is typically used to diagnose contact dermatitis and is not a standard method for diagnosing food allergies in children. Educationally, understanding the differences between these diagnostic methods is essential for pediatric nurses to provide safe and effective care to children with food allergies. By knowing when to use oral food challenges and interpreting the results accurately, nurses can play a critical role in managing food allergies in pediatric patients.

Correct Answer: D

Rationale: The correct answer is D) Urinary alkalinization. In the case of aspirin overdose, which causes salicylate poisoning, urinary alkalinization is the most appropriate therapy to enhance the elimination of aspirin through the urine. Aspirin is a weak acid that is excreted more rapidly in alkaline urine. By alkalinizing the urine, the renal elimination of aspirin is increased, preventing its accumulation and potential toxicity. Option A) Allopurinol is used to decrease uric acid production in conditions like gout and hyperuricemia, but it is not indicated for aspirin overdose. Option B) Forced diuresis with furosemide is not recommended in aspirin overdose as it can lead to volume depletion and electrolyte imbalances without effectively enhancing aspirin excretion. Option C) Hyperhydration alone without urinary alkalinization may not significantly increase aspirin excretion and could potentially exacerbate electrolyte imbalances. In a pediatric nursing context, understanding the appropriate interventions for toxic ingestions is crucial. Educating healthcare providers on the rationale behind treatments for specific poisonings, like the use of urinary alkalinization in aspirin overdose, ensures safe and effective care for pediatric patients. It is essential to grasp the pharmacokinetics and toxic effects of common medications in children to provide optimal care in emergency situations.

Correct Answer: A

Rationale: In this scenario, the most likely diagnosis for a patient with complaints of headache, poor nasal airflow two weeks later is sinusitis (Option A). Sinusitis is characterized by inflammation of the sinuses, leading to symptoms such as headache and nasal congestion. The patient's symptoms of poor nasal airflow align with the hallmark signs of sinusitis. Option B, foreign body, is less likely in this case as the patient's symptoms are more indicative of an inflammatory condition rather than a mechanical obstruction. Rhinitis medicamentosa (Option C) is characterized by rebound nasal congestion due to overuse of topical decongestants, which does not fit the patient's presentation. Choanal stenosis (Option D) refers to a narrowing or blockage of the back of the nasal passage, which would typically present with more severe and persistent symptoms than described. In an educational context, understanding the differential diagnosis of common pediatric respiratory conditions is crucial for nurses caring for children. Recognizing the signs and symptoms of sinusitis, as well as distinguishing it from other conditions like foreign bodies or medication-induced rhinitis, is essential for providing appropriate care and treatment to pediatric patients. This case highlights the importance of clinical reasoning and thorough assessment in pediatric nursing practice.

Correct Answer: D

Rationale: In the context of pediatric nursing and determining specific IgE levels, the advantage of skin testing over RAST is that skin testing is less expensive than RAST. This cost-effectiveness can be crucial in pediatric healthcare settings where resources may be limited. Skin testing involves introducing small amounts of allergen into the skin and observing for an allergic response, making it a relatively simple and cost-effective method for identifying specific IgE sensitivities. Option A, stating that skin testing is not affected by antihistamines, is incorrect. In fact, antihistamines can interfere with skin testing results, making this option an incorrect choice. Option B claims that skin testing has greater sensitivity than RAST, which is not necessarily true. While skin testing can be very sensitive, RAST (Radioallergosorbent Test) is also a highly accurate method for detecting specific IgE levels. Option C mentions that skin testing is semiquantitative, which is true to some extent. However, the degree of quantification in skin testing may vary, and it is not typically considered a fully quantitative method for determining specific IgE levels. In a pediatric nursing context, understanding the advantages and limitations of different allergy testing methods is essential for providing accurate diagnoses and appropriate treatment plans for children with allergies. By choosing the most cost-effective and reliable testing method, healthcare providers can optimize care for their pediatric patients while managing healthcare resources efficiently.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) None of the above. The reason for this is that acute urticaria in a 14-year-old does not typically warrant immediate extensive diagnostic testing such as systematic elimination diets, allergy skin testing, or serum IgE and RAST levels. For a patient presenting with acute urticaria, the first step in management is to focus on symptomatic relief through antihistamines and identifying potential triggers through a detailed history. Most cases of acute urticaria are self-limiting and resolve within a few days to weeks without the need for extensive testing. Systematic elimination diets are more applicable in chronic cases of urticaria where specific food triggers are suspected. Allergy skin testing and serum IgE levels are more commonly used in cases of suspected allergic reactions or in chronic urticaria cases when an allergic component is suspected. From an educational perspective, it is important for nursing students to understand the appropriate approach to managing acute urticaria in pediatric patients. Emphasizing the importance of obtaining a thorough history, providing symptomatic relief, and reserving extensive diagnostic testing for cases where it is clinically indicated are key learning points. This case highlights the significance of evidence-based practice and efficient resource utilization in pediatric nursing care.