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 potential side effect. Optic neuritis is an inflammation of the optic nerve that can lead to vision changes, including blurred vision and color vision disturbances. It is important for pediatric nurses to be aware of this side effect when administering ethambutol to pediatric patients with tuberculosis to monitor for any visual changes and promptly report them to the healthcare provider. A) Isoniazid is a commonly used antituberculosis agent but is not associated with causing optic neuritis. It is important for its hepatotoxicity side effect and monitoring liver function tests. B) Rifampin is another commonly used antituberculosis agent but does not cause optic neuritis. It is known for its side effects like hepatotoxicity and orange discoloration of bodily fluids. C) Pyrazinamide is not known to cause optic neuritis, but it is associated with hepatotoxicity and hyperuricemia. Pediatric nurses need to monitor liver function and uric acid levels when administering pyrazinamide to pediatric patients. Understanding the potential side effects of antituberculosis agents is crucial for pediatric nurses to ensure safe medication administration and monitoring in pediatric patients. By knowing which medications can cause specific adverse effects, nurses can provide better care and promptly address any complications that may arise.

Correct Answer: D

Rationale: The correct answer is D) Large atrial septal defect. Infective endocarditis is an infection of the inner lining of the heart chambers and heart valves. It is commonly associated with turbulent blood flow, which can lead to the deposition of bacteria and subsequent infection. A large atrial septal defect allows for a significant shunting of blood between the atria, which equalizes pressure and minimizes turbulence. This reduces the risk of bacterial deposition and subsequent infective endocarditis compared to the other options provided. In contrast, small ventricular septal defects, severe aortic regurgitation, and severe mitral regurgitation all involve turbulent blood flow, increased pressure gradients, and abnormal flow patterns, which can promote bacterial adherence and increase the risk of infective endocarditis. From an educational standpoint, understanding the relationship between cardiac defects and the risk of infective endocarditis is crucial for pediatric nurses caring for patients with congenital heart diseases. Nurses need to recognize the impact of different cardiac conditions on the risk of complications like infective endocarditis to provide optimal care and preventive measures for their pediatric patients.

Correct Answer: C

Rationale: In the context of pediatric nursing, understanding the signs of active rheumatic fever is crucial for early detection and appropriate management. The correct answer is option C) Persistent joint symptoms, as this is NOT a sign of active rheumatic fever. Persistent joint symptoms are more indicative of conditions like juvenile idiopathic arthritis rather than rheumatic fever. Rheumatic fever typically presents with acute joint pain and inflammation, but these symptoms are usually migratory and not persistent. Option A) New significant murmur of mitral or aortic valvulitis is a classic sign of rheumatic fever due to valvular involvement. Option B) High CRP is also commonly seen in rheumatic fever as it is an inflammatory marker. Option D) High anti-streptolysin O titer is indicative of recent streptococcal infection, which can lead to rheumatic fever. In an educational context, it is important for pediatric nurses to be able to differentiate between the signs and symptoms of various pediatric conditions to provide timely and effective care to their patients. Understanding the key indicators of rheumatic fever can help nurses in assessing and managing patients with this condition.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding the features of acute rheumatic fever, including polyarthritis, is crucial for providing quality care to children. In this question, option B is the correct answer because acute rheumatic fever typically affects large joints such as the knees, ankles, elbows, and wrists more than small joints like those in the hands and feet. Option A is incorrect because polyarthritis in acute rheumatic fever is indeed polyarticular and migratory, involving multiple joints that move from one joint to another. Option C is incorrect because the commonest major manifestation in children with the initial attack of acute rheumatic fever is actually carditis, affecting the heart. Lastly, option D is incorrect because acute rheumatic fever can occur without serological evidence of recent streptococcal infection, known as seronegative acute rheumatic fever. Educationally, this question highlights the importance of recognizing the clinical features of acute rheumatic fever, particularly polyarthritis, in pediatric patients. By understanding these features, nurses can promptly identify and manage acute rheumatic fever, preventing potential complications such as rheumatic heart disease. It underscores the significance of evidence-based practice and clinical knowledge in pediatric nursing to deliver optimal care to children with rheumatic conditions.

Correct Answer: B

Rationale: The correct answer is B) Cystic fibrosis. Cystic fibrosis is a genetic disorder that affects the respiratory, digestive, and reproductive systems. In this case, the combination of recurrent wheezing (respiratory symptom), abnormal stool (digestive symptom), and marked failure to thrive (nutritional symptom) are classic signs of cystic fibrosis in pediatric patients. Option A) Bronchopulmonary dysplasia is a lung condition that primarily affects premature infants who have been on mechanical ventilation. This condition does not typically present with the combination of symptoms described in the question. Option C) Chronic persistent asthma is a common respiratory condition in children characterized by recurrent episodes of wheezing and breathing difficulties. However, it does not usually cause abnormal stool or failure to thrive. Option D) Missed foreign body aspiration may present with respiratory symptoms such as wheezing but would not explain the presence of abnormal stool and failure to thrive. Educationally, understanding the specific signs and symptoms of pediatric conditions like cystic fibrosis is crucial for healthcare providers working with children. Recognizing these clinical manifestations early can lead to prompt diagnosis and intervention, ultimately improving patient outcomes. It is important for pediatric nurses to be able to differentiate between various conditions based on presenting symptoms to provide appropriate care and support to their patients and families.