A 9-year-old often comes to the school nurse complaining of stomach pains. The teacher says that the child has lately been somewhat aggressive and stubborn in the classroom. What should the school nurse recognize as the possible trigger for these behaviors?
Signs of stress.
Developmental delay.
A physical problem causing emotional stress.
Lack of adjustment to the school environment.
The Correct Answer is A
The correct answer is choice A: Signs of stress.
Choice A rationale:
Children often express stress through physical complaints such as stomach pains, headaches, and fatigue. The 9-year-old's complaints of stomach pains, along with the description of aggressive and stubborn behavior, are indicative of stress. Stressors can include academic pressures, family issues, social challenges, or other emotional factors.
Choice B rationale:
Developmental delay refers to a situation where a child's developmental milestones are significantly delayed compared to their peers. This doesn't align with the presented symptoms of stomach pains, aggression, and stubbornness. These symptoms are more indicative of emotional or psychological distress.
Choice C rationale:
While a physical problem could potentially cause emotional stress, the scenario doesn't provide enough information to directly conclude that a physical problem is the primary trigger. Stomach pains could indeed result from emotional stress, and it's important to consider the child's overall well-being.
Choice D rationale:
Lack of adjustment to the school environment can lead to behavioral and emotional challenges, but it's not the most direct explanation for the symptoms described in the scenario. The combination of stomach pains and behavioral changes suggests a more immediate emotional trigger, which is often stress-related.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C: Administering penicillin.
Choice A rationale:
Imposing strict bed rest for 4 to 6 weeks. This choice is not the most appropriate therapeutic management for rheumatic fever. While rest is important during the acute phase, strict bed rest for 4 to 6 weeks is excessive and could lead to physical deconditioning and psychological distress for the child.
Choice B rationale:
Administering corticosteroids if chorea develops. This choice is relevant to the management of rheumatic fever but is not the primary treatment. Chorea is a movement disorder that can occur as a complication of rheumatic fever. Corticosteroids may be used to manage chorea symptoms, but they are not the mainstay of treatment for rheumatic fever itself.
Choice C rationale:
Administering penicillin. This is the correct choice. Penicillin is the mainstay of treatment for rheumatic fever. It helps eradicate the group A streptococcal infection that triggers the inflammatory response leading to rheumatic fever. Penicillin is essential to prevent further complications such as rheumatic heart disease.

Choice D rationale:
Avoiding salicylates (aspirin). This choice is also relevant to the management of rheumatic fever. Salicylates, including aspirin, are used to relieve symptoms and reduce inflammation. However, in children with acute rheumatic fever, salicylates are contraindicated due to the risk of developing Reye's syndrome, a serious condition that affects the brain and liver.
Correct Answer is D
Explanation
The correct answer is choice D. Give small amounts of favorite fluids frequently to prevent dehydration.
Choice A rationale:
Having the child wear heavy clothing to prevent chilling is not an appropriate nursing intervention for an infant with an elevated temperature. Infants are more susceptible to temperature regulation issues, and heavy clothing could exacerbate their discomfort and potentially raise their body temperature further.
Choice B rationale:
Giving tepid water baths to reduce fever is not recommended for fever management in infants. Tepid baths might cause discomfort and shivering, which could lead to increased heat production and potential elevation of body temperature.
Choice C rationale:
Encouraging food intake to maintain caloric needs is important, but it might not be well-tolerated by an infant with an elevated temperature and upper respiratory tract infection. Infants often have reduced appetite during illness.
Choice D rationale:
Giving small amounts of favorite fluids frequently to prevent dehydration is an appropriate nursing intervention. Fever and elevated temperature can lead to increased fluid loss through sweating and increased respiratory rate. Offering small, frequent fluid intake helps maintain hydration and prevent dehydration. Using favorite fluids can also encourage the child to drink more.
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