Which is not a common cause of hypersensitivity pneumonitis?

Correct Answer: D

Rationale: In this question regarding hypersensitivity pneumonitis, the correct answer is D) Dust mites. Dust mites are not a common cause of hypersensitivity pneumonitis. This condition is typically caused by exposure to organic dusts such as moldy hay, bird droppings, and humidifiers. These organic materials contain allergens that can trigger an immune response in the lungs, leading to inflammation and respiratory symptoms. Moldy hay is a well-known cause of hypersensitivity pneumonitis, especially in agricultural settings. Bird droppings, particularly from pigeons and parrots, contain proteins that can induce an immune response in susceptible individuals. Humidifiers, if not cleaned properly, can harbor mold and bacteria which when inhaled, can lead to hypersensitivity pneumonitis. Educationally, understanding the common causes of hypersensitivity pneumonitis is crucial for healthcare providers, especially those working with pediatric patients. Recognizing the sources of exposure can aid in prevention strategies and early intervention for affected individuals. By knowing the specific triggers, healthcare professionals can educate families on how to reduce exposure and mitigate the risk of developing hypersensitivity pneumonitis.

Correct Answer: A

Rationale: In a pediatric patient with ventricular fibrillation, the immediate action to be taken is to provide a DC shock (option A). This is because ventricular fibrillation is a life-threatening arrhythmia that requires prompt defibrillation to restore normal sinus rhythm. Defibrillation is the primary intervention for ventricular fibrillation as it helps stop the chaotic electrical activity in the heart and allows the heart to re-establish an effective rhythm. Giving anti-arrhythmic drugs (option B) or epinephrine (option C) may be necessary after defibrillation if the initial shock is unsuccessful in restoring a normal rhythm. However, these medications are not the first-line treatment for ventricular fibrillation. Atropine (option D) is not indicated for ventricular fibrillation and is more commonly used for bradycardia. Educationally, it is crucial for healthcare providers, especially those working in pediatric settings, to be well-versed in the management of cardiac arrhythmias in children. Understanding the appropriate sequence of interventions in pediatric cardiac emergencies, such as ventricular fibrillation, is vital for providing timely and effective care to critically ill pediatric patients. By prioritizing defibrillation in ventricular fibrillation cases, healthcare providers can improve outcomes and potentially save lives.

Correct Answer: C

Rationale: Wilson's disease is an autosomal recessive disorder characterized by the abnormal accumulation of copper in the body, primarily in the liver and brain. The correct answer is C) Urinary copper is high. Explanation of the correct answer: In Wilson's disease, there is a defect in the ATP7B gene, which leads to impaired hepatic copper transport and excretion. As a result, copper accumulates in the liver and spills into the bloodstream, leading to increased urinary copper excretion. Therefore, urinary copper levels are elevated in Wilson's disease, making option C the correct answer. Explanation of why the other options are wrong: A) Serum ceruloplasmin is low in Wilson's disease, not high. Ceruloplasmin is a copper-carrying protein synthesized in the liver, and its levels are decreased in Wilson's disease due to impaired copper metabolism. B) Wilson's disease is an autosomal recessive disorder, not dominant. It requires two copies of the defective gene (one from each parent) for the disease to manifest. D) Hepatic dysfunction in Wilson's disease can range from mild to severe, with symptoms such as hepatomegaly, jaundice, and liver failure. It is not usually mild, making this option incorrect. Educational context: Understanding the key features of Wilson's disease, including the mechanisms of copper accumulation and the associated laboratory findings, is crucial for pediatric nurses caring for patients with this condition. By knowing that urinary copper is high in Wilson's disease, nurses can collaborate with the healthcare team to diagnose and manage the disease effectively. This knowledge also helps in educating patients and families about the importance of treatment compliance and regular monitoring to prevent complications associated with copper overload.

Correct Answer: C

Rationale: The correct answer is C) Ventricular septal defect. In pediatric nursing, it is essential to understand congenital heart diseases. A ventricular septal defect is the most common congenital acyanotic heart disease, accounting for about 20-30% of all congenital heart defects. This defect involves an opening in the septum between the two ventricles, leading to a shunting of blood from the left ventricle to the right ventricle. As a result, oxygen-rich blood mixes with oxygen-poor blood, causing increased pulmonary blood flow and potential for complications like heart failure. Option A, Coarctation of the aorta, is a narrowing of the aorta and is a cyanotic heart disease, not acyanotic. Option B, Atrial septal defect, involves an opening in the septum between the atria, leading to a shunting of blood from the left atrium to the right atrium, but it is less common than ventricular septal defects. Option D, Pulmonary valve stenosis, is a narrowing of the pulmonary valve, which can obstruct blood flow from the right ventricle to the pulmonary artery but is not the most common acyanotic heart disease in pediatrics. Understanding the prevalence, pathophysiology, and clinical implications of various congenital heart diseases is crucial for pediatric nurses to provide effective care, educate families, and monitor for potential complications in pediatric patients with these conditions.

Correct Answer: A

Rationale: In Tetralogy of Fallot (TOF), the correct statement is A) "Squatting is a common clinical presentation." This is true because squatting increases systemic vascular resistance, which helps reduce the right-to-left shunting of blood in TOF, improving oxygenation. Squatting is a compensatory mechanism seen in children with TOF during hypercyanotic spells. Option B) "Hypercyanotic spells could be helped by IV digoxin" is incorrect. IV digoxin is not used to manage hypercyanotic spells in TOF. The primary treatment for hypercyanotic spells includes providing supplemental oxygen, knee-to-chest positioning, and IV fluids. Option C) "Brain abscess is a well-known neurological complication in infancy" is incorrect. While TOF can lead to some neurological complications, brain abscess is not a common complication associated with TOF. Option D) "The typical murmur heard on auscultation is pansystolic in timing" is incorrect. In TOF, the typical murmur heard on auscultation is a harsh systolic ejection murmur, not pansystolic. Educationally, understanding the clinical presentations, complications, and management of TOF is crucial for pediatric nurses. Recognizing the signs of hypercyanotic spells and knowing appropriate interventions can be life-saving for children with TOF. By knowing the correct clinical manifestations and management strategies, nurses can provide safe and effective care for pediatric patients with TOF.