Nokea
A 9-year-old child is brought to the clinic with a fever, rash, and swollen joints. The nurse notes that the child had a sore throat two weeks ago that was not treated. What condition should the nurse suspect?
- A. Scarlet fever
- B. Rheumatic fever
- C. Kawasaki disease
- D. Juvenile rheumatoid arthritis
Correct Answer: B
Rationale: In this scenario, the child's symptoms of fever, rash, and swollen joints following an untreated sore throat two weeks ago are indicative of rheumatic fever. Rheumatic fever can develop as a complication of untreated streptococcal infections, leading to systemic inflammation and affecting various organs, including the joints. This condition manifests with symptoms such as fever, rash, and swollen joints, aligning with the child's presentation in this case. Scarlet fever typically presents with a sandpapery rash and strawberry tongue but does not involve joint inflammation. Kawasaki disease presents with fever, rash, and mucous membrane changes but does not typically involve joint swelling. Juvenile rheumatoid arthritis can cause joint swelling but is not directly linked to a recent untreated sore throat.
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When caring for a child experiencing severe asthma symptoms, which medication should the practical nurse anticipate being administered first?
- A. Inhaled corticosteroids.
- B. Oral corticosteroids.
- C. Short-acting beta agonists.
- D. Leukotriene receptor antagonists.
Correct Answer: C
Rationale: In the management of acute asthma exacerbations, the first-line medication for quick relief of bronchoconstriction is a short-acting beta agonist, such as albuterol. These medications help to rapidly open up the airways, providing immediate relief to the patient. Inhaled corticosteroids are more commonly used for long-term control of asthma symptoms, while oral corticosteroids and leukotriene receptor antagonists are often reserved for more severe or chronic cases. Therefore, in a child experiencing severe asthma symptoms, the practical nurse should anticipate the administration of short-acting beta agonists as the initial intervention to provide quick relief and improve breathing.
A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family?
- A. The mother is a single parent and lives with her parents
- B. The mother states the baby is irritable during feedings
- C. The infant's formula has been changed twice
- D. The diaper area shows severe skin breakdown
Correct Answer: D
Rationale: Severe skin breakdown in the diaper area is significant as it indicates a potential severe issue that needs immediate attention to prevent further complications. Skin breakdown can lead to infections and discomfort for the infant, making it a priority in planning care for this family. The other findings, such as the mother's living situation, baby's irritability during feedings, or formula changes, are important but do not pose immediate risks to the infant's health compared to severe skin breakdown.
A male infant with bronchiolitis is brought to the clinic by his mother. The infant is congested and febrile with a capillary refill of 2 seconds. Which information should the nurse discuss with the mother?
- A. Encourage the infant to play
- B. Limit the amount of oral intake
- C. Keep the infant isolated from others
- D. Place the infant on their back for naps
Correct Answer: C
Rationale: Bronchiolitis is a highly contagious respiratory infection commonly caused by viruses. Isolating the infant from others is crucial to prevent the spread of the infection to other vulnerable individuals, especially those with weakened immune systems. Encouraging play may not be appropriate as the infant is sick and needs rest. Limiting oral intake might be necessary if the infant is having difficulty swallowing due to respiratory distress. Placing the infant on their back for naps is a safe sleep practice but not the priority in this situation where preventing transmission of the infection is crucial.
A 10-year-old child is brought to the emergency department after falling from a bicycle and hitting their head. The nurse notes that the child is drowsy and has a headache. What is the nurse's priority action?
- A. Perform a full neurological assessment
- B. Administer pain medication
- C. Allow the child to rest quietly
- D. Check the child's immunization status
Correct Answer: A
Rationale: In a child who has fallen and hit their head, presenting with drowsiness and headache, the priority action for the nurse is to perform a full neurological assessment. This is crucial to evaluate the extent of the head injury and monitor for signs of increased intracranial pressure, which could indicate a more severe traumatic brain injury. Administering pain medication or allowing the child to rest quietly are not appropriate initial actions without first assessing the neurological status. Checking the child's immunization status is important for overall health but is not the priority in this acute situation.
A 10-year-old child is admitted to the hospital with a diagnosis of acute glomerulonephritis. The nurse notes that the child has edema and elevated blood pressure. What is the nurse's priority action?
- A. Administer antihypertensive medication as prescribed
- B. Monitor the child's urine output
- C. Elevate the child's legs to reduce edema
- D. Restrict the child's fluid intake
Correct Answer: A
Rationale: In a child with acute glomerulonephritis presenting with edema and elevated blood pressure, the priority action for the nurse is to administer antihypertensive medication as prescribed. Managing blood pressure is essential to prevent further complications associated with the condition, such as worsening kidney function and cardiovascular strain. Monitoring urine output is important but not the priority over managing elevated blood pressure. Elevating the child's legs may help with edema but addressing the elevated blood pressure takes precedence. Fluid intake restriction may be necessary in some cases, but it is not the immediate priority when managing acute glomerulonephritis with edema and hypertension.