Which is not a common cause of food protein-induced enterocolitis syndrome?

Correct Answer: C

Rationale: Rationale: The correct answer is C) Rice. Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity that primarily affects infants and young children. Rice is not a common cause of FPIES compared to milk, soy, and wheat. Milk and soy are two of the most common triggers for FPIES in infants. Cow's milk protein and soy protein are often implicated in FPIES reactions due to their allergenic potential. Wheat is another common trigger for FPIES, as gluten-containing grains can provoke inflammatory responses in the gastrointestinal tract. Educational Context: Understanding the common triggers for FPIES is crucial for pediatric nurses to provide optimal care for young patients. By recognizing the typical culprits like milk, soy, and wheat, nurses can assist in identifying and managing FPIES cases effectively. Moreover, knowledge of less common triggers like rice (Option C) helps in differentiating between various food-related conditions and ensuring accurate diagnosis and treatment plans for pediatric patients with gastrointestinal issues.

Correct Answer: D

Rationale: The correct answer is D) Presence of click. In pediatric nursing, the presence of a click during auscultation is indicative of a pathological murmur. Clicks are often associated with structural abnormalities in the heart valves or septa, such as in cases of congenital heart defects like tetralogy of Fallot or mitral valve prolapse. Clicks are typically heard immediately after the S1 heart sound. Option A) Splitting of the second heart sound at the pulmonary area is a normal finding in pediatric patients and is not necessarily indicative of a pathological murmur. It can be due to the closure of the aortic and pulmonary valves occurring at slightly different times. Option B) Ejection systolic in timing refers to the timing of the murmur and does not specifically point towards a pathological murmur. Ejection murmurs are common in children and can be benign. Option C) Systolic murmur best heard in the supine position is a nonspecific finding and does not definitively suggest a pathological murmur. The position of the patient can affect the intensity of murmurs but is not diagnostic of a pathological condition. In an educational context, understanding the characteristics of different heart sounds and murmurs is crucial for pediatric nurses to accurately assess and identify cardiac abnormalities in children. Recognizing the significance of specific auscultatory findings can lead to prompt referral, diagnosis, and management of pediatric patients with cardiac issues. Regular practice and exposure to various heart sounds will help nurses develop their auscultation skills and enhance their ability to differentiate between normal and abnormal findings.

Correct Answer: C

Rationale: In pediatric nursing, understanding the implications of HBsAg positivity in infants is crucial for providing comprehensive care. The correct answer is C) 90%. Infants who are HBsAg-positive have a high likelihood of developing chronic hepatitis or becoming chronic carriers of the hepatitis B virus. Option A) 10% is incorrect because the percentage of HBsAg-positive infants who progress to chronic hepatitis or carrier state is much higher. Option B) 30% is also incorrect as it underestimates the risk associated with HBsAg positivity in infants. Option D) 70% is incorrect as it overestimates the percentage and does not accurately reflect the high likelihood of chronicity in HBsAg-positive infants. Educationally, this question highlights the importance of early detection and management of hepatitis B in infants to prevent long-term complications. Nurses need to be aware of the high risk these infants face and be prepared to provide appropriate care, support, and education to families. Understanding the natural history of hepatitis B infection in infants is essential for pediatric nurses to advocate for timely interventions and follow-up care.

Correct Answer: D

Rationale: In the context of pediatric nursing and specifically neonatal cholestasis, hepatobiliary scintigraphy is an important diagnostic study. This test involves the use of a radioactive tracer to assess the liver, gallbladder, and bile ducts. In neonates with cholestasis, this study is crucial in determining the presence of bile flow obstruction, which is a common cause of jaundice in this population. The other options provided (A) Chest X-ray, (B) CT abdomen, and (C) Echocardiography are not typically used as primary diagnostic studies for neonatal cholestasis. A Chest X-ray may show some nonspecific findings related to cholestasis but is not definitive. A CT abdomen is not the first-line study for evaluating cholestasis in neonates due to concerns about radiation exposure. Echocardiography is used to assess cardiac structure and function, not liver or biliary tract pathology. Educationally, understanding the appropriate diagnostic studies for neonatal cholestasis is crucial for pediatric nurses caring for these patients. It allows for timely and accurate diagnosis, which is essential for implementing appropriate interventions and improving patient outcomes. By knowing the specific diagnostic tests and their indications, nurses can contribute effectively to the interdisciplinary team caring for neonates with cholestasis.

Correct Answer: D

Rationale: In the context of pediatric nursing and shock, understanding the stages of shock is crucial for timely and effective intervention. The correct answer, option D, which states "Microvascular perfusion becomes marginal," is characteristic of the uncompensated stage of shock. In this stage, the body's compensatory mechanisms are no longer able to maintain adequate tissue perfusion, leading to impaired microvascular perfusion. Option A, inadequate perfusion of vital organs, while important in shock, is a broader concept that can occur in both compensated and uncompensated stages. Option B, stating that blood flow is normal or increased and may be redistributed, is more indicative of the compensated stage where compensatory mechanisms are still functioning to maintain perfusion. Option C, vital organ function is maintained, is also more reflective of the compensated stage where the body is still able to maintain organ function despite reduced perfusion. Educationally, understanding the progression of shock stages is vital for nurses caring for pediatric patients as early recognition and intervention can significantly impact outcomes. By recognizing the signs and symptoms of uncompensated shock, nurses can initiate appropriate interventions to prevent further deterioration and improve patient outcomes. This knowledge underscores the importance of ongoing assessment, early recognition, and prompt intervention in the care of pediatric patients in shock.