Which is not a common cause of urticaria in children?

Correct Answer: D

Rationale: The correct answer is D) Contact allergens. Urticaria, commonly known as hives, in children is frequently caused by various factors like foods, drugs, and infections due to their developing immune systems and increased sensitivity. Contact allergens are not as common a cause compared to the other options listed. Foods, especially common allergens like peanuts, eggs, and dairy, can trigger urticaria in children with food sensitivities or allergies. Drugs, including antibiotics, pain medications, and vaccines, can also lead to hives as a sign of an allergic reaction. Infections, such as viral illnesses like the common cold or bacterial infections, can provoke an immune response that manifests as urticaria in children. Understanding the common triggers of urticaria in children is vital for healthcare providers, especially nurses preparing for the Pediatric NCLEX exam. By recognizing these causes, they can quickly assess and provide appropriate care for children experiencing hives. It is crucial to differentiate between various triggers to ensure accurate diagnosis and effective treatment for pediatric patients with urticaria.

Correct Answer: D

Rationale: The correct answer is D) Tentorial herniation. In cases of tentorial herniation, increased intracranial pressure causes the brain to herniate downward through the tentorial notch, leading to compression of the oculomotor nerve. This compression results in a unilateral dilated and fixed pupil, known as a "blown pupil." Option A) Organophosphates are cholinesterase inhibitors that can lead to excessive stimulation of the parasympathetic nervous system, causing miosis (constricted pupils) rather than mydriasis (dilated pupils). Option B) Anticholinergics cause mydriasis by blocking the parasympathetic input to the iris sphincter muscle, resulting in dilated pupils bilaterally rather than unilaterally. Option C) Narcotics can also cause miosis through their effects on the parasympathetic nervous system, leading to constricted pupils rather than dilated fixed pupils. Understanding the differential effects of these substances on pupil size and reactivity is crucial for nurses caring for pediatric patients, especially in emergency situations where rapid assessment and identification of potential neurological issues are essential for patient outcomes. Recognizing the specific signs associated with tentorial herniation, such as a dilated and fixed pupil, can prompt swift intervention and prevent further neurological deterioration.

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.