A nurse providing care to a child diagnosed with chronic otitis media with effusion (OME) will assess for which sign/symptom?

The correct answer is choice D. Perinatal transmission of HIV is when HIV is passed from a woman with HIV to her child during pregnancy, childbirth, or breastfeeding.

Breast milk from an infected mother can contain HIV and infect the baby.

Choice A is wrong because HIV can be transmitted at any stage of pregnancy, not only in the third trimester.

Choice B is wrong because needlestick injury is not a common mode of perinatal transmission of HIV. It is more likely to occur among health care workers who are exposed to contaminated needles or sharp objects.

Choice C is wrong because HIV can also be transmitted through the ingestion of amniotic fluid, but it is not the only way. Amniotic fluid is the fluid that surrounds and protects the baby in the womb.

Verbalizing the importance of monitoring for medication side effects.

Graves’ disease is an autoimmune disorder that causes hyperthyroidism, which means the thyroid gland produces too much thyroid hormone. This can lead to symptoms such as weight loss, increased appetite, nervousness, irritability, insomnia, heat intolerance, and palpitations. The medication methimazole is used to treat Graves’ disease by blocking the synthesis of thyroid hormone. However, methimazole can also cause serious side effects such as liver damage, agranulocytosis (low white blood cell count), and allergic reactions.

Therefore, the priority nursing goal for a 14 year old diagnosed with Graves’ disease is to verbalize the importance of monitoring for medication side effects and reporting them to the health care provider.

Choice A is wrong because relieving constipation is not a priority goal for Graves’ disease. Constipation is more likely to occur in hypothyroidism, which is the opposite of hyperthyroidism.

Choice B is wrong because allowing the adolescent to make decisions about whether or not to take medication is not a priority goal for Graves’ disease. While it is important to respect the adolescent’s autonomy and involve them in their care plan, they also need to understand the risks and benefits of taking medication and the consequences of not taking it.

Choice D is wrong because developing alternative educational goals is not a priority goal for Graves’ disease. Graves’ disease can affect the academic performance of adolescents due to cognitive and emotional changes caused by hyperthyroidism.

However, this does not mean that they need to change their educational goals. They may need extra support and accommodations from their teachers and parents to cope with their condition and achieve their potential.