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?

"Has your son had a sore throat recently?"

"Was your son born with this cardiac defect?"

"Are you aware that your son will have to be in isolation?

"Has your child had any injuries recently?"

Answer and Explanation

The Correct Answer is A

A. "Has your son had a sore throat recently?"

This question is relevant because acute rheumatic fever often occurs as a complication of untreated or inadequately treated streptococcal throat infection (strep throat). A recent history of sore throat could indicate a preceding streptococcal infection, which is an important predisposing factor for the development of acute rheumatic fever.

B. "Was your son born with this cardiac defect?"

This question is less relevant in the context of acute rheumatic fever. Acute rheumatic fever is not a congenital heart defect; it is an inflammatory condition that affects the heart valves following streptococcal infection. While it's important to assess the child's cardiac health, asking about congenital heart defects may not directly relate to the current condition.

C. "Are you aware that your son will have to be in isolation?"

This question is not applicable to acute rheumatic fever. Acute rheumatic fever is not a contagious condition that requires isolation. It is an autoimmune response triggered by streptococcal infection and does not pose a risk of transmission to others.

D. "Has your child had any injuries recently?"

Inquiring about recent injuries is not directly related to acute rheumatic fever. Acute rheumatic fever is an inflammatory condition primarily triggered by streptococcal infection and is not caused by physical injuries.

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Correct Answer is D

Explanation

A. A 45-degree head elevation: This position can help facilitate venous drainage and reduce intracranial pressure. Elevating the head of the bed may aid in preventing the accumulation of cerebrospinal fluid (CSF) in the brain, which is important after VP shunt insertion to maintain proper drainage. However, this position alone may not be sufficient.

B. On the nonoperative side: Placing the child on the nonoperative side can help reduce pressure on the side where the shunt was inserted, minimizing discomfort and the risk of disruption or displacement of the shunt. However, this position may not directly affect CSF drainage.

C. Prone: Placing the child prone (lying face down) is generally not recommended after VP shunt insertion. This position may increase pressure on the head and interfere with proper CSF drainage, potentially leading to complications.

D. Supine: Placing the child supine (lying on their back) is typically recommended after VP shunt insertion. This position helps promote proper drainage of CSF through the shunt system without placing undue pressure on the surgical site. It also allows for easy monitoring of the child's condition and surgical site.

A. Machine like murmur B. Chronic hypoxemia C. Cyanosis with crying D. Weak pulse

Correct Answer is A

Explanation

A. Machine-like murmur.

This option is correct. A characteristic clinical manifestation of a large patent ductus arteriosus is a continuous "machine-like" murmur heard on auscultation. This murmur is typically heard best at the upper left sternal border and may radiate to the back.

B. Chronic hypoxemia.

Chronic hypoxemia is not typically a primary manifestation of a large PDA. While PDA can lead to increased pulmonary blood flow and potentially contribute to pulmonary congestion, chronic hypoxemia may not be a prominent feature unless complications such as heart failure develop.

C. Cyanosis with crying.

Cyanosis with crying is more commonly associated with cyanotic congenital heart defects such as tetralogy of Fallot. While PDA can contribute to cyanosis in certain circumstances, it is not typically a consistent clinical manifestation.

D. Weak pulse.

A weak pulse is not typically associated specifically with a large PDA. Infants with PDA may have bounding pulses due to increased blood flow through the ductus arteriosus.

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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?

Nursing Test Bank

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