Which of these antituberculosis agents can cause optic neuritis?

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 this question, the correct answer is D) Large atrial septal defect. A large atrial septal defect poses the least risk of developing infective endocarditis among the options provided. This is because the blood flow through a large atrial septal defect is typically not turbulent enough to cause endothelial damage, reducing the likelihood of bacterial colonization and subsequent infection. Option A) Small ventricular septal defect, option B) Severe aortic regurgitation, and option C) Severe mitral regurgitation all involve turbulent blood flow across the defect or valve, leading to endothelial damage. This damage creates a conducive environment for bacteria to adhere and cause infective endocarditis. Educationally, understanding the relationship between the size of the defect/regurgitation and the risk of infective endocarditis is crucial for pediatric nurses. It highlights the importance of monitoring and managing congenital heart defects and valvular issues to prevent complications such as infective endocarditis. Nurses need to assess and educate patients and families on the risks associated with different cardiac conditions to provide comprehensive care.

Correct Answer: C

Rationale: In the context of pediatric nursing, it is crucial to differentiate between signs of active rheumatic fever to ensure accurate diagnosis and appropriate treatment. The correct answer, option C, "Persistent joint symptoms," is not typically associated with active rheumatic fever. Option A, "New significant murmur of mitral or aortic valvulitis," is a common sign of active rheumatic fever due to valvular damage. Option B, "High CRP," is also indicative of inflammation, which is often elevated in active rheumatic fever. Option D, "High anti-streptolysin O titer," is a marker of recent streptococcal infection, which can lead to rheumatic fever. Educationally, understanding the clinical manifestations of rheumatic fever is essential for pediatric nurses to provide quality care. Recognizing the signs and symptoms helps in early detection, prompt intervention, and preventing complications. By grasping the nuances between different signs, nurses can contribute to improved patient outcomes and overall healthcare quality in pediatric settings.

Correct Answer: B

Rationale: In the context of pediatric nursing and rheumatic fever, understanding the features of polyarthritis is crucial for accurate diagnosis and treatment. The correct answer is option B: Equally affect large and small joints. In acute rheumatic fever, polyarthritis typically affects larger joints such as the knees, ankles, elbows, and wrists, rather than equally affecting large and small joints. Option A, polyarticular and migratory, is correct as polyarthritis in acute rheumatic fever presents with inflammation in multiple joints that shift from one joint to another over a short period of time. Option C is incorrect as the commonest major manifestation in children with the initial attack of acute rheumatic fever is carditis, not polyarthritis. Option D is incorrect because polyarthritis in acute rheumatic fever is not always associated with positive serological evidence of recent streptococcal infection. Educationally, this question highlights the importance of recognizing the clinical features of acute rheumatic fever, particularly polyarthritis, in pediatric patients. Nurses need to be familiar with the typical joint involvement patterns to differentiate acute rheumatic fever from other conditions and provide appropriate care. Understanding these distinctions can lead to timely interventions and improved outcomes for pediatric patients with rheumatic fever.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Cystic fibrosis. Cystic fibrosis is a genetic disorder that affects the lungs and digestive system. Recurrent wheezing, abnormal stool (often greasy and bulky due to malabsorption), and marked failure to thrive are classic symptoms of cystic fibrosis in pediatric patients. Option A) Bronchopulmonary dysplasia is a lung condition primarily seen in premature infants who have received prolonged oxygen therapy. While wheezing may be present, abnormal stool and failure to thrive are not typical features of bronchopulmonary dysplasia. Option C) Chronic persistent asthma can present with recurrent wheezing, but abnormal stool and marked failure to thrive are not characteristic of asthma. Asthma typically does not cause significant issues with growth and weight gain as seen in cystic fibrosis. Option D) Missed foreign body aspiration would present with acute respiratory symptoms rather than the chronic, recurrent nature of the symptoms described in the question. Educationally, this question highlights the importance of recognizing the constellation of symptoms that point towards specific pediatric conditions. Understanding the key clinical features of common pediatric disorders like cystic fibrosis is crucial for pediatric nurses to provide timely and appropriate care to their patients. Recognizing these symptoms early can lead to prompt diagnosis and intervention, ultimately improving patient outcomes.