A child with a history of strep throat presents with fever, shortness of breath, abdominal pain, and a very painful and swollen shoulder joint. Based on this history and presentation, what medical condition should be suspected?
Kawasaki disease
Rheumatoid heart disease
Coarctation of the Aorta
Dextro-transposition of the great arteries
The Correct Answer is B
A. Kawasaki disease typically presents with fever, conjunctivitis, rash, swollen hands/feet, and lymphadenopathy, not following strep throat or with joint pain as a primary feature.
B. Rheumatic heart disease is a complication of rheumatic fever, which can follow an untreated or inadequately treated streptococcal throat infection. The child’s symptoms—fever, shortness of breath (carditis), abdominal pain, and painful swollen joint (arthritis)—are classic signs of rheumatic fever, which can lead to long-term cardiac damage.
C. Coarctation of the aorta is a congenital condition involving narrowing of the aorta and typically presents with differential blood pressure between extremities, not joint swelling or post-streptococcal symptoms.
D. Dextro-transposition of the great arteries is a cyanotic congenital heart defect that presents in newborns, not older children with post-infectious symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Obtaining a throat culture is contraindicated in suspected epiglottitis because it can cause laryngospasm and complete airway obstruction.
B. Placing the child in an upright position (such as the tripod position) helps to maximize airway patency and ease respiratory distress. This is a safe and supportive measure while preparing for definitive care.
C. While a lateral neck x-ray may be helpful in diagnosis, transporting the child can worsen distress, and airway stabilization takes priority before any diagnostic procedures.
D. Never attempt to visualize the epiglottis with a tongue depressor in suspected cases—this can trigger airway obstruction and is only done in a controlled setting like the OR with emergency airway support available.
Correct Answer is B
Explanation
A. Sexual abusers can come from any socioeconomic or marital status; being unemployed and unmarried is not a consistent or defining characteristic.
B. A common and dangerous tactic among sexual abusers is to manipulate or coerce children into keeping the abuse a secret. This may involve threats, bribes, guilt, or emotional manipulation, making it difficult for victims to disclose abuse.
C. Many abusers repeatedly abuse the same victim and may have multiple victims, making this statement inaccurate.
D. In most cases, abusers are known to the victim and often to the family, such as relatives, family friends, or trusted authority figures.
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