A nurse is providing discharge instructions to a parent and his school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include?
Apply cool compresses for 20 min every hour.
Encourage the child to take a 45-minute nap daily.
Allow the child to stay at home on days when her joints are painful.
Administer prednisone on an alternate-day schedule.
The Correct Answer is D
Choice A reason: wrong because applying cool compresses for 20 minutes every hour is not typically recommended. While cool compresses can help reduce joint swelling and pain, they are usually recommended to be applied for short periods and not as frequently as every hour
Choice B reason: wrong because while rest is important, there is no specific recommendation for a 45-minute nap daily. Adequate rest should be balanced with physical activity, which is essential for maintaining joint function and muscle strength
Choice C reason: wrong because allowing the child to stay at home on days when her joints are painful may lead to prolonged inactivity, which can worsen joint stiffness and reduce muscle strength. It’s important to encourage regular movement and activity as tolerated
Choice D reason: This is correct because prednisone is a corticosteroid used to reduce inflammation in conditions like juvenile idiopathic arthritis, and an alternate-day schedule can be effective in managing symptoms while minimizing side effects
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A: A barking cough is not a finding that indicates that the treatment has been effective, but rather a symptom of acute laryngotracheobronchitis, which is also known as croup. Croup is a condition that causes inflammation and narrowing of the upper airway and produces a characteristic barking or seal-like cough. A barking cough may persist for several days after the onset of croup and does not reflect the severity of the airway obstruction.
Choice B: Decreased stridor is a finding that indicates that the treatment has been effective, as stridor is a sign of airway obstruction caused by acute laryngotracheobronchitis. Stridor is a high-pitched, noisy breathing sound that occurs when the air passes through the narrowed airway. Stridor may be inspiratory, expiratory, or biphasic,
depending on the level of obstruction. Decreased stridor means that the airway is less obstructed and the child can breathe more easily.
Choice C: Improved hydration is not a finding that indicates that the treatment has been effective, but rather a goal of treatment for acute laryngotracheobronchitis. Dehydration can worsen the symptoms and complications of croup by thickening the mucus and increasing the risk of infection. Improved hydration can help thin out the mucus and prevent dehydration. Hydration can be improved by encouraging oral fluids, administering intravenous fluids, or providing humidified air.
Choice D: Decreased temperature is not a finding that indicates that the treatment has been effective, but rather a possible outcome of treatment for acute laryngotracheobronchitis. Fever may or may not be present in croup, depending on the cause and severity of the condition. Fever can be caused by viral or bacterial infection, inflammation, or dehydration. Decreased temperature can indicate that the infection or inflammation is resolving or that the dehydration is corrected.
Correct Answer is A
Explanation
Choice A: Encouraging the parents to rock the infant is an appropriate action for a nurse to take, as it can provide comfort, security, and bonding for the infant who is recovering from surgery. Rocking can also soothe the infant's pain and distress and promote sleep and relaxation.
Choice B: Administering blood thinners as needed for pain is not an appropriate action for a nurse to take, as blood thinners are not analgesics and can cause bleeding complications in an infant who is postoperative. Blood thinners are medications that prevent or reduce blood clotting, which can increase the risk of hemorrhage or hematoma. The nurse should administer analgesics, such as acetaminophen or ibuprofen, as prescribed by the provider for pain relief.
Choice C: Positioning the infant on her abdomen is not an appropriate action for a nurse to take, as it can cause pressure or trauma to the surgical site and increase the risk of infection or dehiscence. Positioning the infant on her abdomen can also impair the infant's breathing and oxygenation and increase the risk of sudden infant death syndrome (SIDS). The nurse should position the infant on her back or side with her head elevated and supported.
Choice D: Offering the infant a pacifier is not an appropriate action for a nurse to take, as it can cause suction or friction on the surgical site and increase the risk of infection or dehiscence. Offering the infant a pacifier can also interfere with the infant's feeding and nutrition and cause nipple confusion or preference. The nurse should avoid giving the infant anything in her mouth except for a bottle or breast with a special nipple that does not touch the surgical site.
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