A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy?

A. It is a type IV hypersensitivity reaction: Urticaria is typically a type I hypersensitivity reaction mediated by IgE, not a delayed type IV reaction. Type IV reactions involve T-cell–mediated responses, such as contact dermatitis, rather than immediate histamine-mediated reactions.

B. Histamine release leads to vasodilation: Urticaria results from mast cell degranulation and histamine release, which increase vascular permeability and cause local vasodilation. This leads to the characteristic erythema, swelling, and itching associated with hives.

C. Wheals appear first followed by erythema: In urticaria, erythema and wheals usually appear simultaneously as a result of histamine-induced vasodilation and plasma leakage into the dermis. There is no distinct sequence of wheals followed by erythema.

D. The nonpruritic rash blanches with pressure: Urticarial lesions are typically pruritic (itchy), not nonpruritic, and may blanch under pressure due to transient vasodilation. Pruritus is a hallmark symptom distinguishing urticaria from other rashes.

A. Cervical exams should not be performed: Performing a cervical exam in placenta previa can trigger severe hemorrhage because the placenta may partially or completely cover the cervical os. Avoiding exams unless the location is confirmed by ultrasound is standard practice.

B. Symptoms include painful bleeding that is bright red in color: Placenta previa typically causes painless, bright red vaginal bleeding during the second or third trimester. Painful bleeding is more characteristic of placental abruption, making this statement inaccurate.

C. The mother is at risk for placental abruption: While placenta previa itself does not cause abruption, patients may still have overlapping risk factors, and any abnormal placental implantation can complicate labor, making monitoring important.

D. Placenta previa is a result of improper placement of the placenta in the uterus: Placenta previa occurs when the placenta implants low in the uterus, partially or completely covering the cervical os, which is considered improper placement relative to normal implantation in the upper uterine segment.