Which is not a common cause of exercise-induced anaphylaxis?

Correct Answer: D

Rationale: In exercise-induced anaphylaxis, the body's immune system reacts to specific triggers during or after physical activity, leading to symptoms ranging from hives to life-threatening anaphylactic shock. The correct answer, option D (Tomatoes), is not a common cause of exercise-induced anaphylaxis. Tomatoes are not typically associated with this type of allergic reaction. Option A (Wheat), Option B (Shellfish), and Option C (Celery) are common triggers for exercise-induced anaphylaxis. Wheat contains proteins that can trigger allergic reactions, shellfish allergies are well-documented and can be exacerbated by exercise, and celery is known to cause allergic reactions in some individuals. Educationally, understanding the common triggers for exercise-induced anaphylaxis is crucial for healthcare professionals, especially those working with children. Recognizing these triggers can help in the prevention, management, and emergency response to such allergic reactions, ensuring the safety and well-being of pediatric patients during physical activities. It is essential to educate patients, caregivers, and school personnel about these triggers to prevent potentially life-threatening situations.

Correct Answer: A

Rationale: In pediatric resuscitation, the correct dose of adrenaline IV for cardiac arrest is 10 micrograms/kg. This dosage is based on the weight of the child and is crucial for optimizing outcomes during a cardiac event. Administering the correct dose of adrenaline helps in restoring effective circulation and improving the chances of successful resuscitation. Option A is correct because it follows the standard practice guidelines for pediatric advanced life support (PALS) and is the recommended dosage for adrenaline during cardiac arrest in children. Option B (1000 microgram/kg) is incorrect as it is an excessively high dose that can lead to severe side effects such as hypertension, arrhythmias, and increased myocardial oxygen demand, which can be harmful to the child. Option C (10 milligram/kg) is incorrect as it represents a dose that is 1000 times higher than the correct dose, which would be potentially fatal in a pediatric patient. Option D (100 microgram/kg) is also incorrect as it is too low of a dose to be effective in treating cardiac arrest in children. Educationally, understanding the correct dosage of medications in pediatric emergencies is crucial for nurses and healthcare providers working with children. It ensures safe and effective care delivery, especially in high-stress situations like cardiac arrest. By knowing the correct dosages and rationale behind them, healthcare professionals can confidently and competently respond to pediatric emergencies, ultimately improving patient outcomes and survival rates.

Correct Answer: D

Rationale: The correct answer is D) 6 months. In pediatric patients with persistent elevation of transaminases, a minimum duration of 6 months is typically required to diagnose chronic hepatitis. This extended timeframe allows healthcare providers to observe the pattern and consistency of elevated liver enzymes to differentiate between acute and chronic liver conditions. Option A) 9 months is incorrect as it exceeds the typical duration needed for diagnosis and may delay appropriate management for the child. Option B) 2 months and Option C) 4 months are also too short to establish a diagnosis of chronic hepatitis accurately. In an educational context, understanding the timeline required for diagnosis in pediatric patients is crucial for nurses and healthcare professionals caring for children with liver disorders. This knowledge ensures timely and accurate assessment and intervention, leading to improved outcomes for pediatric patients with chronic hepatitis.

Correct Answer: D

Rationale: In pediatric patients, spontaneous bacterial peritonitis (SBP) is a serious condition characterized by the infection of ascitic fluid without an evident intra-abdominal source. The correct answer is option D) Glucose less than 30 mg/dl. In SBP, the ascitic fluid glucose level is typically low due to increased consumption by bacteria. A glucose level less than 30 mg/dl is a key diagnostic criteria for SBP. Option A) Total protein more than 1 gm is incorrect because in SBP, the ascitic fluid protein level is usually low due to leakage of protein into the peritoneal cavity. Option B) Polymorphonuclear leukocytes less than 100 cells/mm3 is incorrect because in SBP, the ascitic fluid typically shows elevated levels of PMN leukocytes, usually greater than 250 cells/mm3. Option C) Culture result polymicrobial is incorrect because SBP is usually caused by a single organism, most commonly Escherichia coli or Klebsiella pneumoniae. Educationally, understanding the diagnostic criteria for SBP is crucial for nurses and healthcare providers working with pediatric patients with liver disease or ascites. Recognizing the signs and symptoms of SBP early can lead to prompt diagnosis and treatment, improving patient outcomes. It is important to remember the specific diagnostic criteria to differentiate SBP from other causes of ascitic fluid infection.

Correct Answer: A

Rationale: The correct answer is A) Right-sided heart failure. Tender hepatomegaly is commonly seen in conditions where there is congestion of blood in the liver, such as in right-sided heart failure. In this condition, the heart is unable to effectively pump blood to the lungs, leading to back up in the right side of the heart and subsequently into the liver, causing hepatomegaly. Option B) Niemann-Pick disease is a rare genetic disorder characterized by the accumulation of lipids in cells, leading to organ damage. While hepatosplenomegaly is a common feature, it is typically not tender. Option C) Biliary atresia is a congenital condition where there is obstruction of bile flow from the liver to the gallbladder. This can lead to hepatomegaly, but it is usually not tender. Option D) Gaucher's disease is another genetic disorder where there is a buildup of a fatty substance in certain organs. While hepatomegaly can occur, it is not typically tender. Educationally, understanding the differential diagnoses of hepatomegaly in pediatric patients is crucial for nurses and healthcare providers. Recognizing the underlying causes can guide appropriate diagnostic workup and treatment interventions. In the context of the NCLEX exam, this question assesses the test-taker's knowledge of pediatric hepatobiliary conditions and their associated clinical presentations.