A nurse at a community clinic is caring for a toddler.
The client is at risk for
The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"B"}
Rationale for correct answers:
Hemolytic uremic syndrome (HUS) is a triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. It typically follows infection with Shiga toxin-producing E. coli O157:H7, especially in children after ingestion of undercooked beef. Bloody diarrhea and abdominal pain are hallmark prodromal symptoms. Lab findings in HUS include:
- Hemoglobin ↓ (<11 g/dL in toddlers)
- Platelets ↓ (<150,000/mm³)
- Creatinine ↑ (>0.5 mg/dL in toddlers)
- LDH ↑ due to hemolysis
- Schistocytes on peripheral smear
Rationale for incorrect Response 1 options:
A. Acute rheumatic fever is a post-streptococcal autoimmune condition affecting joints, heart, and CNS. It does not present with diarrhea or hemolysis.
B. Toxic epidermal necrolysis is a severe mucocutaneous reaction, often drug-induced, with widespread epidermal detachment—not associated with diarrheal illness.
D. Acute appendicitis presents with localized right lower quadrant pain, fever, and vomiting, not bloody diarrhea or hemolytic anemia.
Rationale for incorrect Response 2 options:
A. Post-streptococcal infection causes rheumatic fever or glomerulonephritis, not HUS.
C. Viral enteritis (e.g., rotavirus) causes watery diarrhea without blood or hemolysis.
D. Parasitic infection (e.g., Giardia) causes prolonged watery diarrhea, not bloody diarrhea or HUS.
Take-home points:
- HUS should be suspected in children with bloody diarrhea post E. coli O157:H7 exposure.
- Differentiate HUS from appendicitis, rheumatic fever, and viral/parasitic gastroenteritis based on clinical and lab findings.
- Early recognition is critical to prevent renal failure; monitor CBC, creatinine, and urinalysis.
- Avoid antibiotics and antidiarrheals in suspected E. coli O157:H7 to reduce HUS risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Preparing medications for the week is a common and effective strategy for medication management, particularly for clients with complex medication regimens or memory issues. This practice, often done using pillboxes, helps ensure medication adherence and reduces the risk of missed doses or accidental overdoses. It's a proactive and safe habit that doesn't typically require further assessment.
Choice B rationale
Having to turn the head completely to see things beside them is a significant finding that suggests a limitation in peripheral vision. This could be indicative of various ophthalmological conditions, such as glaucoma, retinitis pigmentosa, or cataracts, all of which require professional evaluation. This finding is not a normal part of aging and warrants further assessment to prevent vision loss and promote safety.
Choice C rationale
Changing a hearing aid battery weekly is a normal and expected part of maintaining the device's functionality. The lifespan of a hearing aid battery varies depending on usage, but a weekly change is well within the typical range. This statement does not indicate a problem with the client's health or their ability to care for themselves.
Choice D rationale
Preparing all of their own meals is a positive indicator of a client's functional independence and ability to perform activities of daily living. It suggests they have the physical and cognitive capacity to plan, shop for, and cook meals, which is a sign of good health and well-being. This statement does not require further assessment.
Correct Answer is B
Explanation
Choice A rationale
Creating a free exercise program for adults who have cardiovascular disease is an example of tertiary prevention. Tertiary prevention aims to prevent disease complications and improve the quality of life for individuals who already have a health condition. This intervention focuses on managing the existing disease rather than preventing its initial occurrence in a healthy population.
Choice B rationale
Implementing immunization clinics is a classic example of primary prevention. Primary prevention activities are designed to prevent the onset of a disease or injury by targeting healthy individuals. Immunizations work by stimulating a person's immune system to create antibodies, thereby preventing the development of infectious diseases before they occur in the community.
Choice C rationale
Providing tuberculosis screenings is a form of secondary prevention. Secondary prevention focuses on the early detection and treatment of a disease to prevent it from progressing. Screening for tuberculosis allows for the identification of asymptomatic individuals who may have been exposed, enabling prompt treatment to prevent the development of active disease and further transmission.
Choice D rationale
Administering immunoglobulin after exposure to a disease is considered secondary prevention. This intervention aims to prevent the development of an illness in an individual who has already been exposed to a pathogen, thereby halting or minimizing the progression of the disease. It is not preventing the initial exposure, but rather the subsequent clinical illness.
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