Nokea
Which of the following initial physical findings indicate the development of carditis in a child with rheumatic fever?
- A. Heart murmur.
- B. Low blood pressure.
- C. Irregular pulse.
- D. Anterior chest wall pain.
Correct Answer: A
Rationale: A heart murmur is a hallmark of carditis in rheumatic fever, indicating valvular involvement. Other findings may occur but are less specific.
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Which of the following statements by the mother of a toddler diagnosed with nephrotic syndrome indicates that the mother has understood the nurse's teaching about this disease?
- A. My child really likes chips and bologna. I guess we'll have to find something else.
- B. We'll have to encourage lots of liquids. Did you say about 4 liters every day?
- C. We worry about the surgery. Do you think we should do direct donation of blood?
- D. We understand the need for antibiotics. I just wish the antibiotics could be given by mouth.
Correct Answer: A
Rationale: Shows understanding of dietary restrictions.
The parents of a child who requires skeletal traction are unable to visit their child for more than one hour a day because of their jobs. The nurse should:
- A. Encourage the parents to spend more time with the child.
- B. Arrange for volunteers or staff to provide companionship.
- C. Suggest the parents adjust their work schedules.
- D. Provide the child with a phone to contact the parents.
Correct Answer: B
Rationale: Arranging companionship helps meet the child's emotional needs when parents are unavailable due to work constraints.
An 11-year-old child has been diagnosed with Grave's disease and is to start drug therapy. Which of the following instructions should be included in the teaching plan for the child's mother and teacher?
- A. Continue with the same amount of schoolwork and homework.
- B. Understand that mood swings are rare with this disorder.
- C. Limit the amount of food that is offered to the child.
- D. Provide the child with a calm, nonstimulating environment.
Correct Answer: D
Rationale: A calm environment reduces stress and exacerbation of hyperthyroidism symptoms like anxiety. Schoolwork may need adjustment, mood swings are common, and food restriction is unnecessary.
On a home visit following discharge from the hospital after treatment for severe gastroenteritis, the mother tells the nurse that her toddler answers "No!" and is difficult to manage. After discussing this further with the mother, the nurse explains that the child's behavior is most likely the result of which of the following?
- A. Beginning leadership skills.
- B. Inherited personality trait.
- C. Expression of individuality.
- D. Usual lack of interest in everything.
Correct Answer: C
Rationale: Toddlers often assert independence through oppositional behavior.
An 18-month-old with a congenital heart defect is to receive digoxin twice a day. The nurse should instruct the parents about which of the following?
- A. Digoxin enables the heart to pump more effectively with a slower and more regular rhythm.
- B. Signs of toxicity include loss of appetite, vomiting, increased pulse, and visual disturbances.
- C. Digoxin is absorbed better if taken with meals.
- D. If the child vomits within 15 minutes of administration, the dosage should be repeated.
Correct Answer: A
Rationale: Digoxin improves heart function by increasing contractility and regulating rhythm. Toxicity signs are correct but not the focus here, absorption is not meal-dependent, and repeating a vomited dose risks overdose.