A 4-year-old patient with cystic fibrosis is hospitalized with an acute pulmonary exacerbation. When the patient is admitted, he is clutching a soiled, tattered, stuffed dog. His mother says, "He insisted on bringing the dog with him. It really is filthy.". Which nursing action is most appropriate?

Have the child choose a place in his room for the dog where he can see it but it is beyond his reach.

Tell the mother that it is all right to keep the dog with him.

Suggest to the mother that she tell the child that she will bring the dog back after taking it home to wash it.

Suggest to the mother that she choose a replacement from the stuffed animals in the playroom.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Allowing the child to have the soiled stuffed dog within sight but out of reach respects his attachment to the comfort object while maintaining hygiene standards of the hospital environment. The child's emotional well-being is crucial, and separation from a beloved item during a hospital stay can be distressing. Placing the dog in view but inaccessible helps strike a balance between comfort and infection control.

Choice B rationale:

While the mother's desire to keep the dog with the child is understandable, infection control is a concern in a hospital setting. Allowing the soiled object to remain in close proximity could compromise the child's health.

Choice C rationale:

Suggesting that the mother take the dog home to wash it and bring it back later might cause unnecessary distress for the child, who may worry about being separated from the comfort object for an extended period.

Choice D rationale:

Choosing a replacement from the playroom's stuffed animals could be unsettling for the child, as his attachment is to his specific dog. The familiarity of his own toy is likely to provide more comfort during the hospitalization. .

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Correct Answer is B

Explanation

Choice A rationale:

Polyarthritis is a manifestation of rheumatic fever, but it is not the primary manifestation. The main manifestation is carditis, involving inflammation of the heart's valves and structures.

Choice B rationale:

Carditis is a hallmark manifestation of rheumatic fever. It involves inflammation of the heart's valves and structures, leading to murmurs and potential long-term cardiac damage.

Choice C rationale:

Janeway lesions are not associated with rheumatic fever. They are painless, small erythematous or hemorrhagic macules on the palms and soles, typically seen in infective endocarditis.

Choice D rationale:

Subcutaneous nodules are not a primary manifestation of rheumatic fever. These nodules, which are firm and nontender, may develop over bony prominences in cases of severe rheumatic fever.

Choice E rationale:

Cervical lymphadenopathy is not a characteristic manifestation of rheumatic fever. This type of lymphadenopathy is more commonly seen in infections or lymphatic malignancies.

A. Expiratory wheezing. B. Inspiratory crackle. C. Expiratory grunting. D. Inspiratory stridor.

Correct Answer is A

Explanation

Choice A rationale:

Expiratory wheezing is characteristic of asthma exacerbation. It indicates airway constriction and narrowing, leading to difficulty in exhaling and resulting in a high-pitched sound during expiration.

Choice B rationale:

Inspiratory crackle is not typically associated with asthma. Crackles are often heard in conditions involving fluid-filled airways, such as pneumonia.

Choice C rationale:

Expiratory grunting is not a common finding in asthma. Grunting sounds may be present in infants with respiratory distress, indicating the difficulty they experience while exhaling.

Choice D rationale:

Inspiratory stridor is not a usual manifestation of asthma. Stridor is more commonly related to upper airway obstruction, often seen in croup or epiglottitis.

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A 4-year-old patient with cystic fibrosis is hospitalized with an acute pulmonary exacerbation. When the patient is admitted, he is clutching a soiled, tattered, stuffed dog. His mother says, "He insisted on bringing the dog with him. It really is filthy.". Which nursing action is most appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse would expect a client with rheumatic fever to have which manifestations on assessment?

Correct Answer is B

Explanation

Which adventitious breath sound would a nurse expect to auscultate in a child admitted with an asthma exacerbation?

Correct Answer is A

Explanation

A 3-week-old patient is hospitalized for surgical repair of hypertrophic pyloric stenosis. On the third postoperative day, the mother expresses concern that her infant vomited approximately one-fourth of his feeding. Which response by the nurse would be most appropriate at this time?

A 15-year-old patient with a closed head injury is admitted to the pediatric intensive care unit and is intubated. The nurse should monitor the patient for which symptom?

What information should a nurse plan to give the parents of a child recently diagnosed with autism spectrum disorder?

A 2-week-old infant is seen in the well-baby clinic. As a nurse is assessing the client, which finding would present as a sign of congenital hip dysplasia?

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A 13-year-old with severe scoliosis is admitted for insertion of Harrington rods. In preparing the patient for postoperative care, the nurse should provide which information?

When a 9-year-old child feels nauseous and vomits after a cardiac catheterization, which is the priority nursing intervention?

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