A. Immunoglobulin E is involved in allergic reactions and is not used in the treatment of Kawasaki disease. Heparin is an anticoagulant and not typically indicated in KD treatment.
B. Immunoglobulin G is used in KD, but ACE inhibitors are not part of the standard treatment regimen for this condition.
C. Immunoglobulin E is incorrect, and while ibuprofen is an NSAID, aspirin is preferred in Kawasaki disease due to its antiplatelet and anti-inflammatory properties.
D. The standard treatment for Kawasaki disease includes intravenous immunoglobulin G (IVIG) and aspirin. IVIG helps reduce inflammation and the risk of coronary artery aneurysms, while aspirin reduces fever, inflammation, and prevents blood clots.

A. Coarctation of the aorta is a congenital narrowing of the aorta, typically after the branches that supply the upper body. This results in increased blood pressure in the upper extremities and decreased perfusion (and lower blood pressure) in the lower extremities.
B. Clubbing and shortness of breath are more characteristic of chronic hypoxemia, often seen in cyanotic congenital heart defects such as Tetralogy of Fallot, not coarctation of the aorta.
C. Cyanosis is typically associated with defects that cause mixing of oxygenated and deoxygenated blood, such as transposition of the great arteries or tetralogy of Fallot, not coarctation.
D. Pedal edema is more commonly associated with right-sided heart failure and is not a hallmark sign of coarctation in pediatric clients.

A. Fatigue is a common symptom in terminally ill children, but it is not the one identified in research as receiving the least relief.
B. Respiratory distress is also common, especially in the final days, but symptom relief is typically addressed through oxygen therapy or medications like opioids or benzodiazepines.
C. Pain is one of the most commonly reported and under-relieved symptoms in dying children. Studies have shown that despite available pain management strategies, only about 27% of children receive adequate pain relief in their final weeks. This highlights the need for better pediatric palliative care practices.
D. Poor appetite is expected and typically accepted as part of the dying process, and while distressing to families, it is not the most inadequately managed symptom.

A. Respiratory acidosis results from hypoventilation, where CO₂ is retained, leading to increased carbonic acid and decreased blood pH. This is the opposite of what is expected with tachypnea.
B. Metabolic alkalosis is typically caused by loss of gastric acid (e.g., vomiting) or excessive bicarbonate intake, not by altered respiratory rates.
C. Metabolic acidosis occurs in conditions such as diarrhea, renal failure, or diabetic ketoacidosis—not directly from changes in respiratory rate.
D. Sustained tachypnea (rapid breathing), especially in a child, leads to excessive exhalation of CO₂, reducing carbonic acid levels and raising blood pH, resulting in respiratory alkalosis.

A. The pressure dressing is usually removed within 24 hours, not left on for 7 days. Extended dressing use may increase the risk of skin irritation or infection.
B. Strict bed rest is typically recommended for a few hours after the procedure, not for three days. Most adolescents can resume light activity within 24 hours.
C. After a cardiac catheterization, tub baths should be avoided for 2–3 days to prevent infection at the insertion site, but showering is generally safe the next day, provided the site is protected and not scrubbed.
D. Returning to school is typically permitted within 1 to 2 days after the procedure, depending on the child’s condition and physician recommendations—Band-Aid removal is not a relevant factor in determining return to school.

A. Respiratory symptoms are not a primary concern in Kawasaki disease. Although fever may lead to general discomfort, respiratory complications are not characteristic of the condition.
B. While Kawasaki disease does present with skin changes (such as rash, peeling of the skin on the hands and feet), these are secondary findings and not the most critical system to monitor.
C. Gastrointestinal symptoms like abdominal pain may occur, but they are not the major clinical concern or focus for monitoring.
D. Kawasaki disease is a form of vasculitis that primarily affects the cardiovascular system. It can lead to coronary artery aneurysms, myocarditis, and arrhythmias. Continuous monitoring of cardiac function, including echocardiograms and ECGs, is essential for early detection and intervention of life-threatening complications.

A. Children with autism spectrum disorder often have difficulties with social interaction and imaginative play. They benefit from structured and supervised activities to support social skills and reduce anxiety.
B. A reward system for positive behavior (positive reinforcement) is a key behavioral strategy in managing children with autism. It helps encourage desired behaviors and provides consistent feedback in a way the child can understand.
C. Rules should be clear, consistent, and structured. Allowing rules to vary with the child’s behavior can lead to confusion and make behavior management more difficult.
D. Children with autism generally thrive on routine and predictability. A flexible schedule that changes based on interests may increase anxiety and behavioral issues. A structured and predictable routine is more beneficial.

A. Bright red blood indicates active arterial bleeding, most likely from the femoral artery used during the cardiac catheterization. The first priority is to stop the bleeding. Direct pressure should be applied just above the puncture site to help control the bleeding and prevent further blood loss.
B. While notifying the Cath Lab may be necessary later, intervention to stop the bleeding must come first to ensure patient safety.
C. Contacting the Interventional Radiologist may eventually be required, but it is not the first action. Immediate pressure to control bleeding is more urgent.
D. Applying a bulky dressing alone without direct pressure is inadequate in managing arterial bleeding and may delay life-saving intervention.

A. Preparing the family for imminent death is premature and inappropriate as the first action. Hyper-cyanotic spells (Tet spells) are medical emergencies but often reversible with prompt intervention.
B. CPR is not the first response unless the child is unresponsive and pulseless. Tet spells are managed with specific interventions to reduce hypoxia.
C. Assessing for neurological defects may be important later, but during an acute Tet spell, the priority is to restore oxygenation and stabilize the child.
D. The first action during a Tet spell is to administer oxygen to reduce pulmonary vasoconstriction and improve oxygenation. This is often followed by placing the child in a knee-chest position, giving morphine, and preparing for further medical support as needed. Oxygen is the most immediate, non-invasive intervention.

A. Budesonide is an inhaled corticosteroid used for long-term control of asthma. It is not effective in acute situations where rapid bronchodilation is needed.
B. Montelukast is a leukotriene receptor antagonist used for daily maintenance therapy and prevention of asthma symptoms, not for acute attacks.
C. Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid bronchodilation. It is the first-line medication during an acute asthma attack to relieve bronchospasm quickly.
D. Fluticasone is also an inhaled corticosteroid, used for long-term asthma control, and is not appropriate as the first-line treatment in an emergency asthma situation.