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)

Atrial fibrillation on the cardiac monitor

Elevated BUN and creatinine on morning laboratory results

Involuntary movements of extremities

Alopecia

Report of chest pain

Oliguria

Answer and Explanation

Correct Answer : C,E

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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Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"B"}}

Explanation

Eczema (Atopic Dermatitis)

Discomfort level: Pain 3/10 (more likely due to itching than infection)
History of mosquito bites and prolonged scratching
No fever (Temperature 37°C/98.6°F)
Multiple scabs and lesions from scratching

Cellulitis

Redness, warmth, and swelling on the left lower leg
History of skin breakdown (scratching increases infection risk)
Lesions present (Possible infection due to prolonged scratching)

Rationale:

Eczema (Atopic Dermatitis):

Eczema is a chronic inflammatory skin condition that causes itching, dryness, and irritation, often triggered by allergens or skin trauma. The child’s history of mosquito bites and excessive scratching aligns with eczema, as scratching worsens skin irritation and can lead to scabbed lesions. The absence of fever and a mild pain level (3/10) suggest this is primarily an inflammatory response rather than an infection.

Cellulitis:

Cellulitis is a bacterial skin infection that develops when bacteria enter through a break in the skin, often causing redness, warmth, swelling, and pain. The redness, warmth, and swelling on the left lower leg indicate possible early cellulitis, likely caused by bacteria introduced through scratching. However, the absence of fever and only mild pain suggest it may not be a severe infection yet.

Correct Answer is ["120"]

Explanation

Calculate the total drops per hour:

Formula:

Total drops/hour = Volume (mL/hr) x Drop factor (gtt/mL)

=120 mL/hr x 60 gtt/mL

= 7200 gtt/hr

Calculate the drops per minute:

Formula:

Drops per minute (gtt/min) = Total drops/hour / 60 minutes/hour

=7200 gtt/hr / 60 min/hr

= 120 gtt/min

The nurse should set the IV flow rate to deliver 120 gtt/min.

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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)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a 10-year-old client in a pediatric clinic. Exhibits For each potential provider's prescription, click to specify if the assessment findings are consistent with Eczema or Cellulitis. Each finding may support more than 1 disease process.

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"B"}}

Explanation

A nurse is preparing to administer lactated Ringer's solution IV to infuse at 120 mL/hr for a client who has a respiratory disorder. The drop factor on the manual IV tubing is 60 gtt/ml. The nurse should set the IV flow rate to deliver how many gtt/min? (Round to the nearest whole number.)

Correct Answer is ["120"]

Explanation

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