Which manifestations should the nurse expect to find in a child in the early stages of acute hepatitis?

Correct Answer: A

Rationale: In the early stages of acute hepatitis in a child, the nurse should expect manifestations such as nausea, vomiting, and generalized malaise, which are consistent with Option A. This is because acute hepatitis typically presents with non-specific symptoms such as gastrointestinal disturbances and malaise before progressing to more specific signs like jaundice. Option B is incorrect because pain in the left upper quadrant is more commonly associated with conditions like pancreatitis or splenomegaly rather than acute hepatitis in children. Option C is incorrect as yellowing of the skin and sclera (jaundice) usually appears later in the course of hepatitis, not in the early stages as described in the question. Option D is also incorrect as yellowing of the skin and sclera alone without other generalized complaints is less likely to be seen in the early stages of acute hepatitis in children. Educationally, understanding the progression of symptoms in pediatric hepatitis is crucial for nurses to provide timely and appropriate care. Recognizing the early signs allows for prompt intervention and management, potentially preventing further complications. It is important for nurses to be able to differentiate between the various manifestations of liver disorders in children to ensure accurate assessment and care planning.

Correct Answer: A

Rationale: The correct answer is A) food protein allergy. In infants and young toddlers, chronic diarrhea following infectious enteritis can be related to food protein allergy. This is because the inflammation and damage caused by the initial infection can lead to the development of an allergy to certain food proteins, which in turn can trigger chronic diarrhea. Option B) bacterial overgrowth is not typically associated with chronic diarrhea following infectious enteritis in infants and very young toddlers. Bacterial overgrowth is more commonly seen in conditions like small intestinal bacterial overgrowth (SIBO) or malabsorption syndromes. Option C) giardiasis is a specific parasitic infection caused by Giardia lamblia and would present with its own set of symptoms, including diarrhea, but it is not the most likely cause of chronic diarrhea following infectious enteritis. Option D) eosinophilic gastroenteropathy is a condition characterized by high levels of eosinophils in the gastrointestinal tract, leading to inflammation and various gastrointestinal symptoms. While this condition can cause chronic diarrhea, it is not typically the primary concern following infectious enteritis in infants and very young toddlers. Understanding the potential causes of chronic diarrhea following infectious enteritis in young children is crucial for healthcare providers, especially those preparing for the NCLEX exam. Recognizing the role of food protein allergy in this context can help in appropriate management and treatment of the condition, ensuring better outcomes for pediatric patients.

Correct Answer: D

Rationale: Rationale: In Tangier disease, there is a deficiency in the ATP-binding cassette transporter A1 (ABCA1) protein, leading to impaired cellular cholesterol efflux. As a result, individuals with Tangier disease exhibit extremely low levels of plasma cholesterol, not increased levels as seen in the general population. This is why option D, "increased plasma cholesterol," is the correct answer. Option A, "orange tonsils," is a feature of Tangier disease due to cholesterol accumulation in the tonsils, leading to their characteristic orange appearance. Option B, "hepatosplenomegaly," is also seen in Tangier disease due to cholesterol deposition in the liver and spleen. Option C, "relapsing neuropathy," is associated with Tangier disease as a result of lipid deposition in nerve tissues. Understanding the features of Tangier disease is crucial for nurses and healthcare professionals, especially those preparing for the NCLEX exam. Recognizing these distinct clinical manifestations can aid in early diagnosis and appropriate management of patients with rare genetic disorders like Tangier disease. It also highlights the importance of lipid metabolism in maintaining overall health and the consequences of its dysregulation in various diseases.

Correct Answer: B

Rationale: The correct answer is B) Escherichia coli O157:H7. Antibiotics are not indicated and may be detrimental in this foodborne bacterial illness because they can increase the risk of hemolytic uremic syndrome (HUS), a severe complication associated with this strain of E. coli. By disrupting the bacterial cell wall, antibiotics may trigger the release of more toxins, worsening the condition. Enterotoxigenic E. coli (Option A) causes traveler's diarrhea and is typically treated with antibiotics. Enterohemorrhagic E. coli (Option C) can lead to HUS, but antibiotics are still contraindicated due to the risk of exacerbating toxin release. Campylobacter jejuni (Option D) is usually treated with antibiotics as well. In an educational context, understanding the rationale behind not using antibiotics in specific bacterial infections is crucial for nursing students preparing for the NCLEX exam. It emphasizes the importance of evidence-based practice and the potential consequences of inappropriate antibiotic use, highlighting the need for proper assessment and intervention strategies in clinical practice.

Correct Answer: C

Rationale: In this question, the correct answer is C) Yersinia. Yersinia enterocolitica is a bacterium that can cause gastroenteritis. Immunoglobulin A (IgA) nephropathy is a condition where IgA immune complexes deposit in the kidneys, leading to inflammation and damage. Yersinia infection can trigger an immune response that results in IgA nephropathy as an extraintestinal manifestation. A) Salmonella is a common cause of food poisoning but is not typically associated with IgA nephropathy. B) Shigella is another bacterium that causes intestinal infection but is not linked to IgA nephropathy. D) Campylobacter is a common cause of bacterial diarrhea but is not known to be associated with IgA nephropathy. Educationally, understanding the extraintestinal manifestations of enteric infections is crucial for healthcare professionals, especially when considering systemic complications like IgA nephropathy. This knowledge helps in early recognition, appropriate management, and prevention of potential long-term consequences for patients. It reinforces the importance of thorough assessment and understanding of the interconnectedness of different body systems in pediatric patients.