Which of the following actions by the practitioner would be important in the prevention of rheumatic fever?
- A. Encourage routine hypertensive screenings.
- B. Conduct routine occult blood screenings.
- C. Refer children with sore throats for throat cultures.
- D. Recommend salicylates instead for minor discomforts.
Correct Answer: C
Rationale: The correct action to prevent rheumatic fever is to refer children with sore throats for throat cultures (Choice C). Rheumatic fever is caused by an abnormal immune response to a bacterial infection with group A Streptococcus. By promptly diagnosing and treating streptococcal infections with antibiotics, the risk of developing rheumatic fever can be minimized. Conducting throat cultures for children with sore throats helps identify streptococcal infections and allows for appropriate antibiotic treatment, thereby preventing the progression to rheumatic fever. Encouraging routine hypertensive screenings (Choice A) and conducting routine occult blood screenings (Choice B) are not directly related to the prevention of rheumatic fever. Recommending salicylates instead for minor discomforts (Choice D) is contraindicated in cases of suspected or confirmed streptococcal infections due to the risk of worsening symptoms and potentially triggering rheumatic fever.
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A nurse is preparing to test a school-age child's vision. Which eye chart should the nurse use?
- A. Denver Eye Screening Test
- B. Allen picture card test
- C. Ishihara vision test
- D. Snellen letter chart
Correct Answer: D
Rationale: The nurse should use the Snellen letter chart to test a school-age child's vision. The Snellen chart is specifically designed to assess distance vision by having the child read rows of letters of various sizes from a specific distance. This chart is commonly used for vision screenings and has standardized letter sizes that help determine visual acuity. The other options listed - Denver Eye Screening Test, Allen picture card test, and Ishihara vision test - are not typically used for testing visual acuity in the same way the Snellen chart is.
The nurse is providing dietary instructions to a client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:
- A. increasing saturated fat intake and fasting in the afternoon.
- B. increasing intake of vitamins B and D and taking iron supplements.
- C. eating a candy bar if light-headedness occurs.
- D. consuming a low-carbohydrate, high-protein diet and avoiding fasting.
Correct Answer: D
Rationale: Consuming a low-carbohydrate, high-protein diet and avoiding fasting is the best recommendation to control hypoglycemic episodes in clients. When someone has hypoglycemia, their blood sugar levels drop too low. A diet that is low in carbohydrates and high in protein can help regulate blood sugar levels and prevent sudden drops that lead to hypoglycemic episodes. Additionally, avoiding fasting helps maintain a consistent intake of nutrients throughout the day, which is important for managing blood sugar levels. It is essential to eat regular, balanced meals and snacks to keep blood sugar levels stable and prevent hypoglycemia.
The nurse is caring for a client with thrombocytopenia. What is the best way to protect this client?
- A. Limit visits by family members
- B. Encourage the client to use a wheelchair
- C. Use the smallest needle possible for injections
- D. Maintain accurate fluid intake and output records Situation: AIDS cases has been all over the country and yet only few are reported cases due to the stigma attach to it.
Correct Answer: C
Rationale: Thrombocytopenia is a condition characterized by a low platelet count in the blood, which can lead to abnormal bleeding and bruising. Using the smallest needle possible for injections helps minimize the risk of causing bleeding or bruising in clients with thrombocytopenia. Larger needles can cause more tissue damage and increase the chances of bleeding complications in these individuals. Therefore, using the smallest needle possible is the best way to protect the client from potential harm related to their condition.
A newborn is diagnosed with retinopathy of prematurity. What should the nurse know about this diagnosis?
- A. Blindness cannot be prevented.
- B. No treatment is currently available.
- C. Cryotherapy and laser therapy are effective treatments.
- D. Long-term administration of oxygen will be necessary.
Correct Answer: C
Rationale: Retinopathy of prematurity (ROP) is a disorder of the developing retinal blood vessels in premature infants. Cryotherapy and laser therapy are both effective treatments for ROP. These treatments can help prevent vision loss and improve the chances of maintaining good vision. Prompt detection and intervention are key in managing ROP to prevent long-term visual impairment. Therefore, the nurse should be aware that cryotherapy and laser therapy are effective interventions for ROP, contrary to the options suggesting blindness cannot be prevented or no treatment is available. Long-term administration of oxygen can contribute to the development of ROP, so careful monitoring and management of oxygen levels are necessary in premature infants to prevent this condition.
Which is most suggestive that a nurse has a nontherapeutic relationship with a patient and family?
- A. Staff is concerned about the nurse's actions with the patient and family.
- B. Staff assignments allow the nurse to care for same patient and family over an extended time.
- C. Nurse is able to withdraw emotionally when emotional overload occurs but still remains committed.
- D. Nurse uses teaching skills to instruct patient and family rather than doing everything for them.
Correct Answer: A
Rationale: Option A is the most suggestive that a nurse has a nontherapeutic relationship with a patient and family because when the staff is concerned about the nurse's actions with the patient and family, it indicates that there may be issues or red flags in the nurse's interactions. This could imply that the nurse's behavior is not promoting a positive, therapeutic relationship with the patient and family, which is crucial for effective care delivery. Staff concerns may arise due to behaviors that are inappropriate, unprofessional, or lacking empathy, which can hinder the development of a therapeutic relationship and affect the quality of care provided.