Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)?
- A. Chickenpox or influenza
- B. E. coli or staphylococcus
- C. Mumps or streptococcus A
- D. Streptococcus A or staphylococcus
Correct Answer: A
Rationale: Both chickenpox and influenza are viral; during these illnesses, aspirin (a salicylate) is typically discontinued due to the risk of Reye syndrome.
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An 18-month-old with a myelomeningocele is undergoing a cardiac catheterization. The mother expresses concern about the use of dye in the procedure. The child does not have any allergies. In addition to an iodine allergy, which other allergy should the nurse bring to the attention of the catheterization staff?
- A. Soy
- B. Latex
- C. Penicillin
- D. Dairy
Correct Answer: B
Rationale: Children with spina bifida (myelomeningocele) are often allergic to latex; catheter balloons and other materials may contain latex.
A nurse is caring for a child with Down syndrome. Which statement by the parent indicates the need for further teaching?
- A. I will make sure my child has regular hearing screenings.
- B. I will encourage my child to be active and participate in play.
- C. I should monitor my child's thyroid function regularly.
- D. I should avoid giving my child a multivitamin supplement.
Correct Answer: D
Rationale: Children with Down syndrome may benefit from a multivitamin supplement, especially if they are at risk for nutritional deficiencies.
An older male client with long-standing lung disease is admitted to the medical unit for treatment of pulmonary infection. In assessing for signs of increasing hypoxia, which action should the nurse include? (select all that apply)
- A. Monitor dryness of mucous membranes
- B. Check for changes in mentation
- C. Observe color of skin and nailbeds
- D. Note appearance of jugular veins
Correct Answer: B
Rationale: Changes in mentation, skin color, and breathing patterns are key indicators of hypoxia in clients with lung disease.
SVT in children differ from physiologic sinus tachycardia by all the following EXCEPT
- A. sudden onset and termination
- B. persistent ventricular rate of >180 bpm
- C. fixed RR interval on ECG
- D. evident change in heart rate with activity
Correct Answer: D
Rationale: Physiologic sinus tachycardia can show changes in heart rate with activity, unlike SVT which has a fixed rate.
All of the following reduces intensity of first heart sound (S1) except
- A. Mechanical ventilation
- B. Calcific mitral stenosis
- C. Short PR interval
- D. LV dysfunction
Correct Answer: B
Rationale: Calcific mitral stenosis typically increases the intensity of the first heart sound (S1).