Which is the most appropriate prognosis to relate to the parents of the 3-year-old in Question 27 with atopic dermatitis?

Correct Answer: D

Rationale: The most appropriate prognosis to relate to the parents of the 3-year-old with atopic dermatitis is option D) Symptoms will gradually improve over the next several years. This option is correct because atopic dermatitis is a chronic inflammatory skin condition that often improves with age, especially in young children. As children grow older, their immune systems mature, and their skin barrier function strengthens, leading to a decrease in symptoms like itching and rash. Option A) The child will be asymptomatic with standard local treatments is incorrect because atopic dermatitis is a chronic condition that may require ongoing management even if symptoms improve over time. Option B) Symptoms will gradually worsen during childhood, then gradually improve is incorrect as atopic dermatitis typically improves as children grow older due to various factors like changes in the skin structure and immune responses. Option C) Symptoms will exhibit a remittent but progressively worsening course is incorrect as atopic dermatitis does not usually have a progressively worsening course; instead, symptoms may fluctuate but tend to improve over time in many cases. Educationally, it is essential for healthcare providers to communicate accurate and realistic prognoses to parents of children with atopic dermatitis to manage their expectations and provide appropriate support and care. Understanding the natural course of the condition helps parents and caregivers make informed decisions about treatment and long-term management strategies.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding common causes of ocular allergies is crucial for providing effective care to children. In this question, the correct answer is D) Foods. This is because while pollens, animal dander, and mold spores are well-known allergens that can trigger ocular allergies, foods are not a common cause of ocular allergies in comparison to respiratory or skin reactions. Pollens are airborne allergens that can easily come into contact with the eyes, triggering an allergic response. Animal dander, consisting of tiny skin particles shed by pets, can also cause allergic reactions in the eyes. Mold spores, commonly found in damp environments, are another common trigger for ocular allergies. By understanding these common causes of ocular allergies, pediatric nurses can educate parents and caregivers on allergen avoidance strategies, symptom management, and the importance of seeking medical intervention when necessary. Recognizing the distinction between common and uncommon causes of ocular allergies helps healthcare providers deliver targeted and evidence-based care to pediatric patients.

Correct Answer: B

Rationale: In pediatric nursing, understanding congenital heart diseases like tetralogy of Fallot is crucial. Option B, stating that it is the most common cyanotic heart disease in children, is correct. This condition involves four heart defects leading to cyanosis. It is important for nurses to recognize this due to its prevalence and potential severity. Option A is incorrect because the murmur heard in tetralogy of Fallot is not pansystolic but rather a harsh systolic ejection murmur due to pulmonary stenosis. Option C is incorrect as brain abscess is not a typical neurological complication of tetralogy of Fallot. Option D is incorrect as the cardiac silhouette in this condition is typically boot-shaped due to right ventricular hypertrophy. Educationally, understanding these details helps nurses in accurately assessing and managing pediatric patients with congenital heart diseases. Recognizing the signs and symptoms allows for prompt interventions and improved patient outcomes. Nurses play a key role in early detection and ongoing care for children with complex cardiac conditions like tetralogy of Fallot.

Correct Answer: B

Rationale: In the context of pediatric nursing, the best method for airway opening in an arrested child is utilizing an endotracheal tube (Option B). Endotracheal intubation provides a secure airway by directly placing the tube into the trachea, ensuring adequate oxygenation and ventilation in a critical situation like cardiac arrest. This method is preferred over an oropharyngeal airway (Option A), which is suitable for maintaining an open airway in a responsive patient but not in an arrested child where a secure airway is crucial. The option C, "Head tilt and jaw thrust," is a basic maneuver used in CPR to open the airway by lifting the chin and tilting the head. While this is essential in CPR, it may not be sufficient in cases of cardiac arrest in children where advanced airway management like endotracheal intubation is needed. Option D, "Ryle tube," is used for gastric decompression or feeding and is not appropriate for airway management in a child in cardiac arrest. In an educational context, it is vital for pediatric nurses to be proficient in advanced airway management techniques like endotracheal intubation to effectively manage pediatric emergencies. Understanding the rationale behind the correct choice and the limitations of other options is crucial for providing safe and effective care to pediatric patients, especially in critical situations like respiratory or cardiac arrest.

Correct Answer: C

Rationale: In pediatric nursing, understanding the features of acute rheumatic fever is crucial for early recognition and appropriate management. The correct answer, option C, which is joint pain without any objective finding, is suggestive of a minor manifestation of acute rheumatic fever. This is because joint pain is a common symptom seen in acute rheumatic fever, especially in its early stages, and may precede the development of more obvious clinical signs. Option A, serological evidence of recent streptococcal infection, is more indicative of the etiology of acute rheumatic fever rather than a minor manifestation. It is an important diagnostic criterion but not a feature suggestive of a minor manifestation. Option B, a non-pruritic erythematous rash over the trunk with fading center and well margin, is more characteristic of erythema marginatum, a major manifestation of acute rheumatic fever, rather than a minor manifestation. Option D, involuntary purposeless, jerky dysthymic movement of hands and arms, describes chorea, which is another major manifestation of acute rheumatic fever and not a minor feature. Educationally, understanding the different manifestations of acute rheumatic fever is vital for nurses caring for pediatric patients. Recognizing minor manifestations can lead to early intervention and prevention of complications associated with acute rheumatic fever. By knowing the subtle signs and symptoms, nurses can advocate for appropriate diagnostic testing and treatment, ultimately improving patient outcomes.