. A nurse is assisting with the admission of a 9-year-old child who has acute rheumatic fever. When obtaining the client's history, it is appropriate for the nurse to ask the parent which of the following questions?
"Are you aware that your son will have to be in isolation?"
"Has your child had any injuries recently?"
"Has your son had a sore throat recently?"
"Was your son born with this cardiac defect?"
The Correct Answer is C
A. "Are you aware that your son will have to be in isolation?": Acute rheumatic fever does not typically require isolation, so this is not the most relevant question.
B. "Has your child had any injuries recently?": This question is not specifically related to acute rheumatic fever, which is caused by a preceding streptococcal throat infection, not injuries.
C. "Has your son had a sore throat recently?": This is the most appropriate question, as acute rheumatic fever is a complication that can follow a streptococcal throat infection, so identifying a history of recent sore throat is key.
D. "Was your son born with this cardiac defect?": Rheumatic fever is an acquired condition, not a congenital defect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Expiratory Wheezing: Expiratory wheezing is a classic sign of an asthma attack. It occurs due to narrowing and inflammation of the airways, which causes turbulent airflow during exhalation. Wheezing typically gets louder during expiration as the airways are more constricted during this phase of breathing.
B. Fine Crackles: Fine crackles are often heard in conditions like pneumonia or heart failure, where fluid is present in the lungs. They are not a hallmark of asthma.
C. Coarse Rhonchi: Coarse rhonchi are low-pitched sounds often associated with mucous secretions in the larger airways, but they are not the classic finding in asthma, where wheezing predominates.
D. Decreased Breath Sounds at the Lung Bases: Decreased breath sounds can indicate severe respiratory distress or a condition like pleural effusion or atelectasis. However, in asthma, breath sounds are usually more prominent during wheezing and are not typically decreased in the absence of complications.
Correct Answer is B
Explanation
A. Cyanosis with crying: Cyanosis is typically seen in cyanotic heart defects, not in PDA, which is acyanotic.
B. Machine-like murmur: Characteristic of PDA due to continuous blood flow between the aorta and pulmonary artery.
C. Chronic hypoxemia: PDA usually leads to left-to-right shunting, not hypoxemia.
D. Weak pulses: Pulses are typically bounding due to increased blood flow, not weak.
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