Which of the following is a hallmark feature of dermatomyositis?

Correct Answer: D

Rationale: The correct answer to the question is D) All of the above. Dermatomyositis is a rare inflammatory disease that affects the muscles and skin. It is characterized by muscle weakness, which is a hallmark feature of the condition. The weakness typically affects the muscles closest to the trunk of the body, such as those in the hips, thighs, shoulders, upper arms, and neck. In addition to muscle weakness, dermatomyositis presents with a distinctive rash. This rash often appears on the face, eyelids, knuckles, elbows, knees, and back. The rash is typically a purplish-red color and can be itchy or painful. Joint pain, on the other hand, is not a hallmark feature of dermatomyositis. While some individuals with dermatomyositis may experience joint pain as a secondary symptom, it is not a defining characteristic of the condition. Educationally, understanding the key clinical manifestations of dermatomyositis is crucial for healthcare professionals, especially pediatric nurses, who may encounter pediatric patients with this condition. Recognizing the triad of muscle weakness, characteristic rash, and potential joint involvement can aid in early identification, appropriate management, and improved outcomes for children with dermatomyositis.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Reduction in greenhouse gas emissions. Renewable energy sources such as solar, wind, and hydroelectric power generate electricity without emitting harmful greenhouse gases like carbon dioxide, which contribute to climate change. This is a significant benefit of renewable energy as it helps combat global warming and its adverse effects on the environment and human health. Option B) Increased reliance on fossil fuels is incorrect because the whole point of transitioning to renewable energy is to decrease our dependence on fossil fuels, which are finite resources and major contributors to air pollution and climate change. Option C) Higher air pollution is also incorrect as renewable energy sources do not produce air pollutants like sulfur dioxide and nitrogen oxides, which are emitted by burning fossil fuels and contribute to respiratory illnesses and environmental degradation. Option D) Greater water usage is not a benefit of renewable energy either. While some renewable energy technologies may require water for their operation, the overall impact on water resources is much lower compared to conventional power plants that rely heavily on water for cooling. In an educational context, understanding the benefits of renewable energy is crucial for healthcare professionals, including pediatric nurses. Climate change and environmental degradation have direct impacts on children's health, from increased incidence of respiratory diseases to food insecurity and extreme weather events. By promoting renewable energy and sustainable practices, healthcare providers can contribute to a healthier future for the children they care for.

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.