Which of these antituberculosis agents can cause optic neuritis?

Correct Answer: D

Rationale: The correct answer is D) Ethambutol. Ethambutol is known to cause optic neuritis as a side effect, which can lead to visual disturbances and changes in color perception. This occurs due to its toxic effect on the optic nerve. Option A) Isoniazid is an antituberculosis agent that is associated with peripheral neuropathy, especially in patients with pre-existing conditions like diabetes. It does not typically cause optic neuritis. Option B) Rifampin is another antituberculosis agent that is more commonly associated with hepatotoxicity and gastrointestinal disturbances rather than optic neuritis. Option C) Pyrazinamide is known for its hepatotoxic effects and can cause hyperuricemia, arthralgia, and myalgia but is not typically linked to optic neuritis. In pediatric nursing, understanding the potential side effects of medications is crucial for safe and effective patient care. Recognizing the side effects of antituberculosis agents, such as optic neuritis from Ethambutol, helps nurses monitor and manage these adverse effects promptly. This knowledge also aids in patient education and adherence to treatment plans.

Correct Answer: C

Rationale: In pediatric nursing, understanding the complications of common childhood infections like mumps is crucial for providing effective care. The correct answer is C) Meningoencephalitis. Meningoencephalitis, inflammation of the brain and its surrounding membranes, is a serious complication of mumps that can lead to neurological problems, seizures, and even death. This is because the mumps virus can spread to the central nervous system, causing significant damage. Option A) Arthritis is not the most common complication of mumps. While mumps can sometimes lead to joint pain and swelling, arthritis is not the primary concern associated with this infection. Option B) Nephritis, inflammation of the kidneys, is not a typical complication of mumps. Mumps primarily affects the salivary glands and can lead to complications in other organs, but nephritis is not commonly associated with mumps. Option D) Thyroiditis, inflammation of the thyroid gland, is not a common complication of mumps infection. Mumps typically affects the parotid glands, and while it can affect other organs, thyroiditis is not a primary concern in mumps cases. Educationally, understanding the complications of mumps helps healthcare providers anticipate and manage potential issues that may arise in pediatric patients. By knowing that meningoencephalitis is a serious complication of mumps, nurses and other healthcare professionals can monitor for neurological symptoms and intervene promptly to prevent serious consequences. This knowledge is vital in providing comprehensive care to pediatric patients with mumps and ensuring positive outcomes.

Correct Answer: A

Rationale: The correct answer is A) Mitral valve stenosis. A mid-diastolic rumble murmur at the lower left sternal border is a classic auscultatory finding in patients with mitral valve stenosis. This murmur is caused by turbulent blood flow across the narrowed mitral valve during mid-diastole. Option B) Severe mitral incompetence would typically present with a holosystolic murmur, not a mid-diastolic rumble. Option C) Aortic rheumatic carditis with mitral valvulitis would present with different auscultatory findings, possibly an early diastolic murmur. Option D) Large atrial septal defect would present with a wide, fixed split S2 and a systolic ejection murmur, not a mid-diastolic rumble. In pediatric nursing, understanding the characteristic murmurs associated with different structural heart diseases is crucial for accurate assessment and diagnosis. Recognizing these auscultatory findings can help nurses and healthcare providers identify underlying conditions early, leading to timely interventions and improved patient outcomes. Regular practice with review questions like this can enhance clinical reasoning skills and strengthen knowledge in pediatric cardiovascular health.

Correct Answer: D

Rationale: In pediatric nursing, understanding the significance of auscultating diastolic murmurs in a child with a ventricular septal defect (VSD) is crucial. The correct answer is D) All of the above. This is because the presence of a diastolic murmur in a child with VSD can indicate the development of complications such as aortic regurgitation, pulmonary hypertension, or a significant left-to-right shunt. Aortic regurgitation can occur due to the increased volume load on the left ventricle from the left-to-right shunt caused by the VSD. Pulmonary hypertension can develop as a result of increased pulmonary blood flow from the left-to-right shunt, leading to elevated pressures in the pulmonary vasculature. A significant left-to-right shunt can result in increased blood flow from the left ventricle to the right ventricle, causing volume overload on the right side of the heart. It is important for pediatric nurses to be able to recognize these potential complications early through auscultation findings to prompt timely interventions and prevent further cardiac issues in children with VSD. Understanding the pathophysiology behind these complications is essential for providing safe and effective care to pediatric patients with congenital heart defects.

Correct Answer: D

Rationale: In the context of pediatric nursing and the diagnosis of rheumatic fever (RF), it is crucial to understand the criteria for considering RF as 'ACTIVE.' In this case, the correct answer is D) Subcutaneous nodules. Subcutaneous nodules are a major Jones criteria for chronic rheumatic heart disease, not for diagnosing an acute attack of RF. The presence of subcutaneous nodules indicates a more advanced stage of rheumatic heart disease rather than an initial attack of RF. A) Fever of > 38°C for at least 3 consecutive days is a common symptom seen in RF and indicates an active inflammatory process. B) Positive acute phase reactants like elevated erythrocyte sedimentation rate (ESR) and C-reactive protein levels are markers of inflammation and are expected in active RF. C) Elevated anti-streptococcal antibodies are also indicative of an immune response to streptococcal infection, which is associated with RF. Educationally, understanding the criteria for diagnosing and classifying RF as 'ACTIVE' is essential for providing proper care to pediatric patients. Nurses should be able to differentiate between the acute phase of RF and the chronic phase to facilitate appropriate management and prevent complications associated with rheumatic heart disease.