Which of the following is NOT a seronegative spondyloarthropathy?

Correct Answer: D

Rationale: In pediatric nursing, understanding the different types of spondyloarthropathies is crucial for providing comprehensive care to children with these conditions. In this question, the correct answer is D) Rheumatoid arthritis, as it is NOT a seronegative spondyloarthropathy. Rheumatoid arthritis is a systemic autoimmune disorder characterized by the presence of rheumatoid factor in the blood, which is considered seropositive. On the other hand, seronegative spondyloarthropathies, such as ankylosing spondylitis, reactive arthritis, and psoriatic arthritis, do not typically present with rheumatoid factor in the blood. Ankylosing spondylitis is a type of seronegative spondyloarthropathy that primarily affects the spine and sacroiliac joints. Reactive arthritis is characterized by joint inflammation following an infection in another part of the body. Psoriatic arthritis is associated with psoriasis and can affect the joints, skin, and nails. Educationally, understanding the differences between these conditions is essential for accurate diagnosis and appropriate management in pediatric patients. Nurses need to be able to recognize the unique clinical presentations of each condition to provide effective care and support to pediatric patients with spondyloarthropathies.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding the impact of climate change on children's health is crucial. The correct answer to the question, "Which factor contributes most to climate change?" is B) Increased use of fossil fuels. Fossil fuels, such as coal, oil, and natural gas, release greenhouse gases like carbon dioxide when burned, leading to the greenhouse effect and global warming. Increased use of fossil fuels is the primary driver of climate change due to the significant amount of greenhouse gases emitted into the atmosphere. These gases trap heat, leading to rising global temperatures, which can have severe consequences for children's health, including increased respiratory illnesses, infectious diseases, and food insecurity. Deforestation (option A) contributes to climate change by reducing the Earth's capacity to absorb carbon dioxide, but it is not the primary factor. Population growth (option C) and technological advancements (option D) can indirectly impact climate change but do not have the same direct and immediate effect as the increased use of fossil fuels. Educationally, this question highlights the importance of understanding the link between human activities and climate change, especially concerning the health and well-being of pediatric patients. Nurses need to be aware of environmental factors affecting children's health to provide holistic care and advocate for policies that promote a sustainable and healthy future for the pediatric population.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding globalization is crucial as healthcare providers increasingly encounter diverse cultural backgrounds and healthcare practices. The correct answer, B) Cultural homogenization, is associated with globalization as it refers to the process where different cultures become more similar due to global influences. This is relevant in pediatric nursing as it highlights the need for healthcare professionals to be culturally competent and sensitive to the diverse backgrounds of their patients and families. Option A) Decreased international trade is incorrect because globalization typically leads to increased international trade, promoting the exchange of goods and services across borders. Understanding this concept is important for pediatric nurses as it can impact the availability of medical supplies and resources for children around the world. Option C) Isolationist policies are not associated with globalization. In fact, globalization often challenges isolationist policies by promoting interconnectivity and collaboration among countries. Pediatric nurses need to be aware of global health trends and policies to provide the best care for children in an increasingly interconnected world. Option D) Local market growth is not directly linked to globalization in the context of cultural homogenization. While globalization can impact local economies, the focus of this question is on the cultural aspects influenced by globalization rather than economic factors. In pediatric nursing practice, understanding the implications of globalization is essential for providing holistic and culturally sensitive care to children and their families from diverse backgrounds. Being aware of how globalization can impact cultural beliefs, practices, and healthcare access is crucial for pediatric nurses to deliver effective care in today's interconnected world.

Correct Answer: B

Rationale: The correct answer is B) bladder cancer. Intravenous cyclophosphamide is a chemotherapeutic agent that is associated with various long-term complications due to its toxicity. Bladder cancer is not a common long-term complication associated with cyclophosphamide use. A) Bone marrow suppression is a well-known side effect of cyclophosphamide. It can lead to decreased production of blood cells, making patients more susceptible to infections, anemia, and bleeding. C) Leukemia is another potential long-term complication of cyclophosphamide use. Prolonged exposure to this drug can increase the risk of developing secondary cancers, including leukemia. D) Infertility is a significant concern with cyclophosphamide use, especially in women. This drug can cause damage to the ovaries, leading to infertility or premature menopause. Educational context: Understanding the potential long-term complications of medications used in pediatric patients is crucial for pediatric nurses. It allows them to monitor for signs and symptoms, provide appropriate education to patients and families, and collaborate with the healthcare team to minimize risks and manage complications effectively.

Correct Answer: B

Rationale: In the case of a 5-year-old boy with systemic juvenile idiopathic arthritis (sJIA) presenting with systemic manifestations such as fever, hepatosplenomegaly, and pericarditis, the BEST initial treatment is systemic glucocorticoids (Option B). Systemic glucocorticoids are the first-line treatment for sJIA due to their potent anti-inflammatory effects. In this acute systemic inflammatory condition, glucocorticoids can rapidly reduce inflammation and control symptoms like fever, pericarditis, and organomegaly. NSAIDs (Option A) are commonly used in arthritis, but in sJIA with systemic features, systemic glucocorticoids are preferred for their broader anti-inflammatory action. TNF-a inhibitors (Option C) and IL-1 antagonists (Option D) are biologic agents used in refractory cases or when glucocorticoids are not effective. They are not typically considered as initial treatments due to their higher cost, route of administration, and potential side effects in pediatric patients. Educationally, understanding the rationale behind selecting the appropriate initial treatment in sJIA is crucial for pediatric nurses. It highlights the importance of recognizing the specific manifestations of the disease and tailoring treatment to address the underlying inflammatory process effectively while considering the safety and efficacy profiles of different medications in pediatric populations.