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

Correct Answer: C

Rationale: In diagnosing atopic dermatitis in older children and adults, it is crucial to understand the major criteria involved. Angioedema, as identified in option C, is not a major criterion for the diagnosis of atopic dermatitis. This is because angioedema is more commonly associated with urticaria rather than atopic dermatitis. Option A, eczematous or lichenified dermatitis, is a major criterion as atopic dermatitis typically presents with these skin manifestations. Option B, pruritus (itching), is also a key feature of atopic dermatitis and is often a significant symptom reported by patients. Option D, chronic or relapsing course, is another important criterion as atopic dermatitis tends to be a chronic condition with periods of exacerbation and remission. In an educational context, understanding the diagnostic criteria for atopic dermatitis is essential for healthcare professionals, especially pediatric nurses. By knowing the key features and major criteria, nurses can accurately assess, diagnose, and provide appropriate care for patients with atopic dermatitis. This knowledge helps in formulating effective treatment plans and educating patients and their families on managing this chronic skin condition.

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: B

Rationale: In pediatric nursing, understanding the impact of medications on a child's health is crucial. In this case, the correct answer is B) Doxorubicin. Doxorubicin is a well-known chemotherapeutic agent that can cause dilated cardiomyopathy, a condition characterized by the enlargement of the heart's chambers and reduced cardiac function. This adverse effect is attributed to doxorubicin's cardiotoxic properties, which can lead to long-term cardiac complications in pediatric patients undergoing cancer treatment. Now, let's analyze why the other options are incorrect: A) IVIG (Intravenous Immunoglobulin): IVIG is commonly used in pediatric patients for various immune-related conditions but is not associated with causing dilated cardiomyopathy. C) Cyclosporine: Cyclosporine is an immunosuppressive medication used in pediatric patients undergoing organ transplantation. While it can have adverse effects on the heart, dilated cardiomyopathy is not a well-known side effect. D) Methotrexate: Methotrexate is another chemotherapy drug, but dilated cardiomyopathy is not a typical side effect associated with its use in pediatric patients. In an educational context, this question highlights the importance of medication safety and monitoring in pediatric patients. Nurses must be aware of the potential cardiotoxic effects of certain medications, like doxorubicin, to provide comprehensive care and ensure early detection and management of adverse reactions in pediatric patients undergoing treatment for various conditions.

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.