Which of the following is a common feature of Still's disease?

Correct Answer: D

Rationale: Rationale: In pediatric nursing, understanding the features of Still's disease is crucial for accurate assessment and diagnosis. Still's disease, also known as systemic juvenile idiopathic arthritis, is characterized by systemic inflammation affecting multiple organs. The correct answer is D) All of the above (Fever, Rash, Arthritis). Fever is a hallmark of Still's disease, often spiking once or twice daily. This persistent high fever is a distinguishing feature. Rash is another common manifestation, presenting as a salmon-pink maculopapular rash that typically accompanies the fever spikes. Arthritis is also prevalent in Still's disease, with joint inflammation and pain being significant symptoms in affected children. Options A, B, and C are not the sole features of Still's disease but are interconnected and frequently seen together in affected individuals. This question provides a comprehensive overview of the classic triad of symptoms associated with Still's disease, aiding in the recognition and differentiation of this condition from other pediatric disorders. Educationally, this question reinforces the importance of recognizing the clinical presentation of Still's disease in pediatric patients. By understanding the key features, nurses can promptly identify and intervene in the care of children with this condition, leading to improved outcomes and quality of life for the young patients. It emphasizes the need for a holistic approach to pediatric assessment and the significance of recognizing patterns of symptoms in diagnosing complex pediatric conditions.

Correct Answer: C

Rationale: The correct answer is C) indomethacin. Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) known to cause a unique adverse skin reaction called livedo reticularis, which presents as small hypopigmented depressed scars. This particular side effect is more commonly associated with indomethacin compared to other NSAIDs. Option A) celecoxib and option B) meloxicam are also NSAIDs but are not typically associated with this specific skin reaction. Celecoxib is a selective COX-2 inhibitor and meloxicam is a preferential COX-2 inhibitor, both of which have different side effect profiles compared to indomethacin. Option D) ibuprofen is a common NSAID that is not typically associated with the development of small hypopigmented depressed scars after fingernail trauma. Educationally, understanding the side effect profiles of different medications, especially in pediatric patients with rheumatic diseases, is crucial for safe and effective nursing practice. Recognizing unique adverse reactions to medications can help healthcare providers make informed decisions regarding treatment options and monitor patients for potential complications.

Correct Answer: D

Rationale: The correct answer is D) hypertriglyceridemia. In the context of a child with hepatosplenomegaly, lymphadenopathy, high fevers, and suspected macrophage activation syndrome (MAS), hypertriglyceridemia is a key distinguishing feature. MAS is characterized by excessive activation and proliferation of macrophages, leading to a cytokine storm and organ damage. Elevated triglyceride levels are commonly seen in MAS due to dysregulated lipid metabolism as a result of the inflammatory process. Option A) Leucopenia is not a distinguishing feature of MAS and can be present in a variety of conditions, including infections. Option B) ESR (erythrocyte sedimentation rate) is a nonspecific marker of inflammation and is not specific to MAS. Option C) Failing hypofibrinogenemia is not a recognized term in medical literature. Hypofibrinogenemia refers to low fibrinogen levels and is not a specific feature of MAS. In an educational context, understanding the key clinical and laboratory features of MAS is crucial for pediatric nurses to provide timely and appropriate care for children at risk of this potentially life-threatening condition. Recognizing the significance of hypertriglyceridemia in the context of MAS can aid in early diagnosis and intervention, improving patient outcomes.

Correct Answer: A

Rationale: Reactive arthritis, also known as Reiter's syndrome, is an inflammatory condition that occurs as a reaction to an infection in another part of the body. In this case, the correct answer is A) Clostridium difficile as the least likely microorganism to cause reactive arthritis. Clostridium difficile is primarily associated with gastrointestinal infections, particularly antibiotic-associated colitis, and is not typically linked to reactive arthritis. On the other hand, Salmonella paratyphi, Shigella, and Yersinia enterocolitica are known to be associated with reactive arthritis, especially following infections such as food poisoning or gastroenteritis. Educationally, understanding the specific microorganisms that can trigger reactive arthritis is crucial for pediatric nurses as they care for children who may develop this condition. By knowing the likely causative agents, nurses can provide timely interventions, educate families on prevention strategies, and collaborate effectively with healthcare providers for optimal patient outcomes. This knowledge enhances the nurse's ability to assess, plan, and intervene appropriately in pediatric cases of reactive arthritis.

Correct Answer: A

Rationale: Rationale: The correct answer is A) measurement of anti-Ro antibodies. In the context of neonatal lupus, the presence of anti-Ro antibodies in the mother can lead to the development of neonatal lupus in the baby. Neonatal lupus can present with various symptoms, including a rash involving the face and periorbital area after exposure to sunlight. By measuring anti-Ro antibodies in the baby, we can confirm the diagnosis of neonatal lupus. Option B) measurement of anti-La antibodies is incorrect because while anti-La antibodies can also be associated with neonatal lupus, anti-Ro antibodies are more commonly linked to this condition. Option C) cardiac evaluation is not the next immediate step in managing neonatal lupus presenting with a rash. Cardiac evaluation may be needed later if specific cardiac symptoms develop. Option D) hematological evaluation is not the most relevant next step in managing neonatal lupus presenting with a rash. While monitoring blood counts may be necessary in the overall management of the condition, it is not the immediate next step in this scenario. Educational Context: Understanding the association between maternal autoantibodies and neonatal lupus is crucial in pediatric nursing. By recognizing the signs and symptoms of neonatal lupus, nurses can initiate appropriate diagnostic tests like measuring anti-Ro antibodies to confirm the diagnosis promptly. This case highlights the importance of thorough assessment, knowledge of autoantibody implications, and timely intervention in pediatric nursing practice.