Correct Answer: A

Rationale: The correct answer is A: Joint swelling and pain. These are the most common initial symptoms of juvenile idiopathic arthritis, typically affecting multiple joints. Skin rash (choice B), gastrointestinal bleeding (choice C), and neurological deficits (choice D) are not typical initial symptoms of juvenile idiopathic arthritis. Skin rash may be seen in other conditions like dermatitis or systemic lupus erythematosus, gastrointestinal bleeding may be associated with conditions like inflammatory bowel disease, and neurological deficits could be indicative of conditions like multiple sclerosis.

Correct Answer: B

Rationale: When administering medications to a child with hepatic dysfunction, it is crucial to make adjustments in dosage due to altered metabolism. Hepatic dysfunction can affect the way medications are metabolized in the body, potentially leading to drug toxicity or reduced effectiveness. This is why adjusting the dosage is essential to ensure the medication is both safe and efficient. Choices A, C, and D are incorrect because increasing dosing intervals, avoiding all medications, or using only topical medications do not address the specific issue of altered drug metabolism in hepatic dysfunction.

Correct Answer: C

Rationale: The correct answer is C: Epinephrine injection. An epinephrine injection is the primary treatment for an anaphylactic reaction in children. Epinephrine acts quickly to reverse severe symptoms such as difficulty breathing, low blood pressure, and hives. Oral antihistamines, although useful for milder allergic reactions, are not sufficient to manage the potentially life-threatening symptoms of anaphylaxis. Intravenous fluids may be necessary to support blood pressure in a child with anaphylaxis but are not the primary treatment. Antipyretics, on the other hand, are medications used to reduce fever and are not indicated as the primary treatment for an anaphylactic reaction.

Correct Answer: B

Rationale: In laryngotracheobronchitis (croup), a child may become restless due to poor oxygenation. Increasing the oxygen concentration in the oxygen tent is crucial to improve oxygenation levels and manage symptoms effectively. Restraint is not appropriate in this situation, as it may cause distress and worsen the child's condition. Taking the child to the playroom is not indicated when the child requires oxygen therapy. While comforting the child is important, the priority in this scenario is to optimize oxygen delivery to improve respiratory distress.

Correct Answer: A

Rationale: Wheezing is a common symptom of respiratory infections in infants, often associated with coughing and difficulty breathing. It occurs due to the narrowing of the airways. Choice B, 'High appetite,' is incorrect as respiratory infections usually lead to a decrease in appetite rather than an increase. Choice C, 'Increased thirst,' is incorrect as it is not a typical symptom of a respiratory infection in infants. Choice D, 'Lethargy,' can be a symptom of respiratory infections but is not as specific and common as wheezing.