Which is not a major criterion for diagnosis of atopic dermatitis in older children and adults?

Correct Answer: C

Rationale: In the context of pediatric nursing certification practice questions, understanding the major criteria for diagnosing atopic dermatitis is crucial for providing optimal care to pediatric patients. In this question, the correct answer is C) Angioedema, as it is not a major criterion for the diagnosis of atopic dermatitis in older children and adults. Angioedema is not a typical presentation of atopic dermatitis. Instead, the major criteria for diagnosing atopic dermatitis include A) Eczematous or lichenified dermatitis, B) Pruritus, and D) Chronic or relapsing course. Eczematous or lichenified dermatitis refers to the characteristic skin changes seen in atopic dermatitis, such as redness, scaling, and thickening of the skin. Pruritus, or itching, is a common symptom associated with atopic dermatitis. The chronic or relapsing course of the condition is also a key feature in its diagnosis, as atopic dermatitis is a chronic inflammatory skin disorder characterized by flare-ups and periods of remission. Educationally, understanding the diagnostic criteria for atopic dermatitis is essential for nurses working with pediatric patients who may present with this condition. By knowing the major criteria and being able to differentiate them from less common symptoms like angioedema, nurses can effectively assess, diagnose, and manage atopic dermatitis in older children and adults.

Correct Answer: D

Rationale: Rationale: The correct answer is D) Dust mites. Hypersensitivity pneumonitis is an inflammatory response in the lungs to repeated inhalation of organic dust particles. Moldy hay, bird droppings, and humidifiers are common causes of hypersensitivity pneumonitis due to the presence of organic particles that trigger an immune response in susceptible individuals. Moldy hay contains mold spores which can be inhaled and cause an immune response in the lungs. Bird droppings contain proteins and microorganisms that can lead to hypersensitivity pneumonitis, especially in individuals who work in poultry farms or bird-keeping environments. Humidifiers can harbor bacteria and fungi if not properly cleaned, leading to respiratory issues. In an educational context, it is important for pediatric nurses to be aware of common causes of hypersensitivity pneumonitis in order to assess and educate patients and families on prevention strategies. Understanding the triggers can help in identifying potential sources of exposure and implementing interventions to reduce the risk of developing this condition in vulnerable populations, such as children with underlying respiratory conditions or allergies. By comprehensively understanding the different causes of hypersensitivity pneumonitis, pediatric nurses can play a crucial role in promoting respiratory health and providing holistic care to pediatric patients.

Correct Answer: B

Rationale: In pediatric nursing, understanding the potential adverse effects of medications is crucial to providing safe and effective care to young patients. The correct answer to this question is B) Doxorubicin. Doxorubicin is a well-known medication that can cause dilated cardiomyopathy, a condition characterized by the enlargement and weakening of the heart muscle. This adverse effect is particularly important to recognize in pediatric patients, as it can have serious implications for their cardiac function and overall health. IVIG (A), Cyclosporine (C), and Methotrexate (D) are not typically associated with causing dilated cardiomyopathy. IVIG is often used to boost the immune system in certain conditions, Cyclosporine is an immunosuppressant commonly used in transplant patients, and Methotrexate is a chemotherapy drug often used in pediatric oncology. While these medications may have their own potential side effects, dilated cardiomyopathy is not a known risk associated with them. Educationally, this question highlights the importance of medication knowledge and vigilance in pediatric nursing practice. Nurses must be aware of potential adverse effects of medications commonly used in pediatric populations to monitor for signs and symptoms of complications. Understanding the implications of medications like Doxorubicin can help nurses intervene early and prevent serious cardiac issues in their young patients.

Correct Answer: A

Rationale: In a pediatric patient with ventricular fibrillation, the immediate action should be 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 helps to depolarize the heart muscle and allows the sinoatrial (SA) node to regain control of the heart's rhythm. Option B, giving anti-arrhythmic drugs, is not the first-line treatment for ventricular fibrillation in a pediatric patient. While anti-arrhythmic drugs may be used as adjunct therapy, they are not as effective as immediate defibrillation in this emergency situation. Option C, giving Epinephrine, is important in pediatric advanced life support protocols but should come after defibrillation in the management of ventricular fibrillation. Option D, giving Atropine, is used to treat symptomatic bradycardia and not ventricular fibrillation. In an educational context, it is crucial for pediatric nurses to understand the priority actions in managing pediatric cardiac emergencies like ventricular fibrillation. Quick and accurate decision-making can significantly impact patient outcomes in such critical situations. Nurses should be trained in recognizing arrhythmias, understanding the appropriate interventions, and being prepared to respond swiftly to provide life-saving care to pediatric patients experiencing cardiac emergencies.

Correct Answer: C

Rationale: Wilson's disease is an autosomal recessive disorder characterized by impaired hepatic copper transport, leading to copper accumulation in various organs. The correct answer is C) Urinary copper is high. This is because in Wilson's disease, there is impaired excretion of copper into bile, resulting in high levels of copper in the body, including the urine. Option A) Serum ceruloplasmin is high is incorrect because in Wilson's disease, there is decreased ceruloplasmin levels due to impaired synthesis by the liver. Option B) Autosomal dominant disorder is incorrect as Wilson's disease follows an autosomal recessive pattern of inheritance, requiring two copies of the defective gene for the disease to manifest. Option D) Hepatic dysfunction is usually mild is incorrect because Wilson's disease can lead to severe hepatic dysfunction, including hepatitis, cirrhosis, and liver failure if left untreated. From an educational perspective, understanding the pathophysiology of Wilson's disease is crucial for pediatric nurses to recognize and manage this condition in pediatric patients. By knowing the key clinical manifestations and diagnostic findings associated with Wilson's disease, nurses can provide comprehensive care, educate patients and families about the importance of compliance with treatment, and facilitate timely interventions to prevent complications.