Which of the following is true regarding acute epiglottitis?

Correct Answer: A

Rationale: Rationale: Acute epiglottitis is a serious condition that requires prompt recognition and intervention. Option A, "Fulminating course of high fever and drooling of saliva," is the correct answer because it accurately describes a classic presentation of acute epiglottitis in children. The rapid onset of high fever, severe sore throat, and drooling of saliva due to difficulty swallowing are hallmark signs of epiglottitis, indicating airway compromise. Option B, "Absence of toxic manifestations," is incorrect because acute epiglottitis typically presents with toxic manifestations such as high fever, respiratory distress, and drooling. The absence of such signs would be atypical for this condition. Option C, "The most common cause is para-influenza," is incorrect. While para-influenza virus can cause croup, a different upper airway condition, acute epiglottitis is commonly caused by Haemophilus influenzae type b (Hib) bacteria, especially in unvaccinated children. Option D, "Good response to nebulized adrenaline," is incorrect because the primary treatment for acute epiglottitis is securing the airway to prevent complete obstruction. Nebulized adrenaline may be used in croup to reduce airway inflammation but is not the mainstay of treatment for epiglottitis. In an educational context, understanding the key clinical features of acute epiglottitis is crucial for pediatric nurses to quickly recognize and intervene in a potentially life-threatening situation. Nurses must be prepared to initiate emergency protocols to secure the airway and provide appropriate treatment to stabilize the child's condition and prevent respiratory distress or failure. Clinical knowledge and rapid assessment skills are essential for pediatric nurses caring for children with acute respiratory conditions like epiglottitis.

Correct Answer: A

Rationale: In Immune Thrombocytopenic Purpura (ITP), platelet transfusion is indicated when the platelet count falls below 10,000/mm3. Platelet transfusion is necessary at this level to prevent severe bleeding complications in patients with ITP. Platelet counts below 10,000/mm3 put individuals at a higher risk of spontaneous bleeding, especially in critical areas like the brain or gastrointestinal tract. Therefore, prompt intervention with platelet transfusion is crucial to manage these risks. The other options (B) 30,000/mm3, (C) 40,000/mm3, and (D) 50,000/mm3 are incorrect in the context of ITP management. Platelet transfusion is not typically recommended at these higher platelet count levels in ITP because the main issue in ITP is the destruction of platelets rather than a low production of platelets. Transfusing platelets unnecessarily at higher counts can lead to potential risks like transfusion reactions and alloimmunization without providing significant clinical benefits. This question is important for pediatric nurses as they care for children with ITP who may require platelet transfusions. Understanding the appropriate indications for platelet transfusion based on platelet count levels is crucial for providing safe and effective care to pediatric patients with ITP. It highlights the importance of evidence-based practice and tailored interventions in pediatric hematology to optimize patient outcomes.

Correct Answer: C

Rationale: In cases of bicarbonate loss in urine, the compensatory mechanism that occurs is hyperventilation, as indicated by option C. When bicarbonate is lost in the urine, the body tries to maintain acid-base balance by increasing ventilation to blow off carbon dioxide, which helps to decrease acidity in the blood. Option A, extracellular shift of potassium, is not the correct answer because it does not directly relate to compensating for bicarbonate loss. Potassium shifts are more commonly seen in conditions like metabolic alkalosis. Option B, reduction in urine output, is not the correct answer either. While changes in urine output can occur in response to various conditions, it is not the compensatory mechanism for bicarbonate loss in urine. Option D, loss of organic acids in urine, is also incorrect. This choice does not address the specific compensatory mechanism needed to balance bicarbonate loss. In an educational context, understanding the compensatory mechanisms in acid-base imbalances is crucial for pediatric nurses to provide effective care for children with various health conditions. By knowing how the body responds to disturbances in acid-base balance, nurses can monitor patients effectively, intervene promptly, and collaborate with the healthcare team to restore equilibrium. This knowledge ensures optimal patient outcomes and safety in pediatric healthcare settings.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the potential side effects of medications used to treat tuberculosis is crucial. The correct answer to this question is D) Ethambutol. Ethambutol is known to cause optic neuritis, an inflammation of the optic nerve which can lead to vision changes or loss. This adverse effect is important to recognize as early detection and discontinuation of the medication can prevent permanent visual impairment in pediatric patients. Looking at the other options: A) Isoniazid is not associated with causing optic neuritis. It is a common first-line medication for treating tuberculosis. B) Rifampin is another first-line drug for tuberculosis but does not typically cause optic neuritis. C) Pyrazinamide is not known to cause optic neuritis. It is often used in combination with other antituberculosis medications. Educationally, this question highlights the importance of medication side effect awareness in pediatric nursing practice. Nurses need to be vigilant in monitoring for adverse effects, especially those that can have serious consequences like optic neuritis. Understanding the specific side effects of each medication used in pediatric patients is essential for providing safe and effective care.

Correct Answer: D

Rationale: In pediatric practice, diagnosing and managing hypertension is crucial for early intervention and long-term health outcomes. Stage 1 hypertension in children is defined as average SBP or DBP levels between the 95th and 99th percentiles for age, sex, and height on at least three separate occasions. Option A is incorrect because having average levels below the 90th percentile would not meet the criteria for stage 1 hypertension. Option B is also wrong as having levels above the 99th percentile would indicate severe hypertension, not stage 1. Option C, BP > 120/80, is a general reference point for adult hypertension and does not align with pediatric guidelines. Understanding these definitions is vital for pediatric nurses to accurately identify and manage hypertension in children. By recognizing the correct range for stage 1 hypertension, nurses can initiate appropriate interventions, educate families on lifestyle modifications, and collaborate with healthcare providers for further evaluation and treatment. This knowledge ensures comprehensive care and optimal outcomes for pediatric patients at risk for hypertension-related complications.