A nurse is caring for a school-age child who has pertussis. Which of the following actions should the nurse take?
Place the child in a protected environment for 48 hr
Administer the pertussis vaccine.
Report the diagnosis to the public health department.
Restrict oral fluids to 500 mL per day.
The Correct Answer is C
A. Place the child in a protected environment for 48 hr: While isolation might be implemented, 48 hours is not a typical timeframe for pertussis. The contagious period can last for weeks.
B. Administer the pertussis vaccine: The pertussis vaccine is for prevention, not treatment of an active case.
C. Report the diagnosis to the public health department. Pertussis, also known as whooping cough, is a highly contagious respiratory illness. Reporting the case to the public health department allows them to track the spread of the disease and take steps to prevent further outbreaks
D. Restrict oral fluids to 500 mL per day. Restricting fluids can worsen dehydration, especially in a child with a respiratory illness.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Weight loss of 5%: A 5% weight loss is typically indicative of mild to moderate dehydration, not severe.
B. Sunken anterior fontanelle: A sunken anterior fontanel is a sign of severe dehydration in infants as it indicates significant fluid loss.
C. Produces tears when crying: Producing tears is a sign of adequate hydration. Absence of tears would be more concerning for dehydration.
D. Capillary refill time 3 seconds: A capillary refill time of 3 seconds is at the upper limit of normal for infants. In severe dehydration, capillary refill time would typically be longer than 3 seconds.
Correct Answer is B
Explanation
A. "I won't let them use a toy that is straddled for 2 weeks." This is a correct restriction to prevent strain on the surgical area.
B. "I can let them resume all of their physical activities." This is likely not true. Activity restrictions might be necessary for healing.
C. "I'm happy they are no longer at risk of fertility issues when they are older." While orchiopexy can improve the chance of future fertility, it's not a guarantee.
D. "They won't need any pain medications at home." Pain medication might be prescribed for post-surgical discomfort.
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