Which action by the school nurse is important in the prevention of rheumatic fever?
- A. Encourage routine cholesterol screenings.
- B. Conduct routine blood pressure screenings.
- C. Refer children with sore throats for throat cultures.
- D. Recommend salicylates instead of acetaminophen for minor discomforts.
Correct Answer: C
Rationale: Nurses have a role in prevention—primarily in screening school-age children for sore throats caused by group A β-hemolytic streptococci. They can achieve this by actively participating in throat culture screening or by referring children with possible streptococcal sore throats for testing. Cholesterol and blood pressure screenings do not facilitate the recognition and treatment of group A β-hemolytic streptococci. Salicylates should be avoided routinely because of the risk of Reye syndrome after viral illnesses.
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An older female client with long term type 2 diabetes mellitus (DM) is seen in the clinic for a routine health assessment. To determine if the client is experiencing any long-term complication of DM, which assessments should the nurse obtain?
- A. Serum creatinine and blood urea nitrogen (BUN)
- B. Sensation in feet and legs
- C. Skin condition of lower extremities
- D. Visual acuity
Correct Answer: B
Rationale: These assessments are crucial for detecting complications such as neuropathy, nephropathy, and retinopathy.
In truncus arteriosus, all the following are true EXCEPT
- A. VSD is always present
- B. clinical manifestations are characterized by severe cyanosis and the degree of cyanosis are high
- C. both ventricles fail clinically
- D. cyanosis is usually mild
Correct Answer: B
Rationale: Cyanosis is usually mild initially in truncus arteriosus.
Regarding cystic fibrosis:
- A. It is inherited as autosomal recessive
- B. There is increased risk of bronchial carcinoma in late adulthood
- C. Biliary cirrhosis is a recognised feature
- D. In neonates, intestinal obstruction may be the first presentation
Correct Answer: A
Rationale: Cystic fibrosis is an autosomal recessive disorder caused by mutations in the CFTR gene.
In scabies:
- A. Itching is due to sensitisation by the mite
- B. Vesicles may be seen in children
- C. The organism is easily demonstrated
- D. Spread can occur through clothes and bedding
Correct Answer: A
Rationale: Itching in scabies is due to an allergic reaction to the mites and their products, leading to sensitization.
An older woman who experienced a cerebrovascular accident (CVA) has difficulty with visual perception and she only eats half of the food on her meal tray. Her family expresses concern about her nutritional status. How should the nurse respond to the family's concern?
- A. Encourage the family to offer to feed the client when she does not eat her entire meal.
- B. Suggest that the family bring foods from home that the client enjoys
- C. Explain that weight loss will be reversed after the acute phase of the stroke has ended.
- D. Demonstrate the use of visual scanning during meals to the client and family.
Correct Answer: D
Rationale: Visual scanning techniques help the client become aware of the entire meal tray, improving food intake and addressing the family's concerns.