A 3-year-old female patient woke up this morning feeling agitated and with a fever of 103.4° F (39.7° C). She was crying yesterday and reported back pain.

She has a history of asthma controlled by daily cetirizine and occasional albuterol.

She has had two urinary tract infections (UTIs) in the past 4 months.

Given the patient’s history and current condition, which condition is she most likely experiencing, what actions should the nurse take, and what parameters should the nurse monitor?

Administer the prescribed antipyretic

Obstructive uropathy

Albumin

V320

Answer and Explanation

The Correct Answer is A

Choice A rationale
The child’s symptoms of agitation, fever, and back pain, along with a history of asthma and recurrent urinary tract infections (UTIs), suggest that she may be experiencing another UTI1.
UTIs can cause fever and back pain, and the fever can lead to agitation in young children. Administering the prescribed antipyretic would help to reduce the child’s fever and alleviate some of her discomfort.
Choice B rationale
Obstructive uropathy is a condition where the flow of urine is blocked, which can cause pain and kidney damage. While this condition could potentially cause back pain, the child’s other symptoms such as fever and agitation are more indicative of an infection like a UTI1.
Choice C rationale
Albumin is a protein made by the liver that helps keep fluid in the bloodstream so it doesn’t leak into other tissues. It is not a condition but a substance in the body, and therefore would not be the correct answer to the question.
Choice D rationale
V320 is not a known medical condition or term, and therefore would not be the correct answer to the question.

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Correct Answer is B

Explanation

Choice A rationale

Immediately after delivery, the breasts of a new mother are not likely to remain the same as before delivery. Hormonal changes during pregnancy prepare the breasts for lactation, and these changes do not typically revert immediately after delivery.

Choice B rationale

On the first postpartum day, the breasts of a new mother are most likely to be filling and secreting colostrum. Colostrum is the first form of milk produced by the mammary glands, and it usually starts to be produced during pregnancy and continues during the early days of breastfeeding.

Choice C rationale

An immediate let-down response is not typically observed on the first postpartum day. The letdown reflex, which releases milk from the breast, usually becomes more pronounced after the first few days of breastfeeding.

Choice D rationale

While the breasts may become larger due to milk production, they are not typically very tender to touch on the first postpartum day. Tenderness may occur later, especially if complications like engorgement or mastitis develop.

A. Inspect the infant’s ears daily. B. Position the infant prone after feeding. C. Breastfeed frequently. D. Avoid exposure to smoke. E. Avoid exposure to smoke.

Correct Answer is D

Explanation

Choice A rationale

While inspecting the infant’s ears daily can help detect signs of an ear infection early, it does not prevent recurrent otitis media.

Choice B rationale

Positioning the infant prone after feeding does not prevent recurrent otitis media and can actually increase the risk of sudden infant death syndrome.

Choice C rationale

While breastfeeding frequently can provide numerous health benefits for the infant, it does not specifically prevent recurrent otitis media.

Choice D rationale

Avoiding exposure to smoke can help prevent recurrent otitis media in infants. Smoke can irritate the Eustachian tubes, which can lead to fluid buildup and increase the risk of ear infections.

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Naxlex Comprehensive Predictor Exams

On the first postpartum day, the nurse examines a new mother’s breasts. What condition is the nurse most likely to find?

Correct Answer is B

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

The nurse is educating parents on how to prevent recurrent otitis media in their infant. What advice should the nurse give?

Correct Answer is D

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

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