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A home health nurse is collecting data on an adolescent who has cystic fibrosis. The child expresses concern about experiencing increasing episodes of respiratory distress and asks the nurse for insight into the possible reasons. Which of the following responses should the nurse make?

"As a nurse, I can't diagnose what is causing you to have worsening symptoms. However, I will relay this information to your healthcare provider so they can determine what should happen next."

“If you are experiencing worsening respiratory distress, we must get you to the emergency department immediately.”

“It sounds like you may be concerned that your condition could be getting worse. That can be scary tell me more about what you have been experiencing."

"As you know, cystic fibrosis is a respiratory disease. Increased respiratory distress is a characteristic symptom of this disorder."

Answer and Explanation

The Correct Answer is C

A. "As a nurse, I can't diagnose what is causing you to have worsening symptoms. However, we will relay this information to your healthcare provider so they can determine what should happen next." While it is true that nurses cannot diagnose, this response does not address the adolescent’s concerns or encourage them to share more information about their symptoms.

B. "If you are experiencing worsening respiratory distress, we must get you to the emergency department immediately." This response may create unnecessary alarm without first assessing the severity of the symptoms. While severe distress requires urgent care, the nurse should first gather more information.

C. "It sounds like you may be concerned that your condition could be getting worse. That can be scary—tell me more about what you have been experiencing." This is correct because it acknowledges the adolescent's emotions, encourages open communication, and allows the nurse to gather more information before determining the appropriate course of action.

D. "As you know, cystic fibrosis is a respiratory disease. Increased respiratory distress is a characteristic symptom of this disorder." While this statement is factually correct, it dismisses the adolescent’s concern instead of providing reassurance, emotional support, and further assessment.

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Correct Answer is C

Explanation

A. "You should focus solely on cognitive development at home, as professional interventions are not effective for children with fragile X syndrome." This is incorrect. Professional interventions, including speech therapy, occupational therapy, and behavioral therapy, are essential for supporting cognitive and social development in children with fragile X syndrome.

B. "Since your child has cognitive delays, you should avoid social activities that could overwhelm them and hinder their progress." Avoiding social activities can actually be harmful, as children with fragile X syndrome benefit from structured social interactions and support. Instead of avoidance, individualized strategies should be used to help the child participate comfortably.

C. "It's important to work with a multidisciplinary team to address your child's cognitive delays and support their development." This is correct. A multidisciplinary team, including special education teachers, therapists, and healthcare providers, helps ensure the child receives individualized support in cognitive, social, and communication skills.

D. "Cognitive delays in children with fragile X syndrome typically resolve on their own, so there is no need for specialized educational plans or therapies." Cognitive delays in fragile X syndrome do not resolve on their own. Early intervention and specialized education plans (e.g., IEPs) are crucial in maximizing the child’s potential.

A. Atrial fibrillation on the cardiac monitor B. Elevated BUN and creatinine on morning laboratory results C. Involuntary movements of extremities D. Alopecia E. Report of chest pain F. Oliguria

Correct Answer is ["C","E"]

Explanation

A. Atrial fibrillation on the cardiac monitor. Rheumatic fever can cause carditis, but atrial fibrillation is not a typical finding. Instead, valvular damage, tachycardia, or murmurs are more commonly observed.

B. Elevated BUN and creatinine on morning laboratory results. Rheumatic fever primarily affects the heart, joints, skin, and brain, not the kidneys. Elevated BUN and creatinine are more indicative of post-streptococcal glomerulonephritis, a separate complication of streptococcal infection.

C. Involuntary movements of extremities. Sydenham’s chorea, characterized by involuntary, jerky movements, is a classic neurologic manifestation of rheumatic fever. It results from inflammation affecting the basal ganglia of the brain.

D. Alopecia. Rheumatic fever does not cause alopecia. Hair loss is more commonly associated with autoimmune diseases such as lupus, not post-streptococcal complications.

E. Report of chest pain. Chest pain can indicate carditis, a major criterion for rheumatic fever. Inflammation of the heart's endocardium, myocardium, or pericardium may lead to pain, murmurs, or heart failure symptoms.

F. Oliguria. Decreased urine output is more commonly seen in post-streptococcal glomerulonephritis rather than rheumatic fever, as rheumatic fever primarily affects the heart, joints, and nervous system.

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A home health nurse is collecting data on an adolescent who has cystic fibrosis. The child expresses concern about experiencing increasing episodes of respiratory distress and asks the nurse for insight into the possible reasons. Which of the following responses should the nurse make?

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A nurse is reinforcing teaching to the parents of a 6-year-old child who has fragile X-syndrome and is manifesting cognitive delays. Which of the following statements concerning coordination of care should the nurse reinforce?

Correct Answer is C

Explanation

A nurse is collecting data from the chart of a child who has streptococcal pharyngitis after being admitted for suspected rheumatic fever. Which of the following findings should the nurse identify as an indication of possible rheumatic fever? (Select All that Apply)

Correct Answer is ["C","E"]

Explanation

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