The nurse caring for a toddler with Kawasaki disease who is receiving intravenous immunoglobulin for severe coronary inflammation is planning discharge teaching for the parents. Which instruction should the nurse provide during the discharge education?

Plan for a follow-up echocardiogram occurring in 4 to 6 weeks.

Resume the toddler's normal immunization schedule.

Irritability and tinnitus are expected for up to 2 weeks.

Manage joint pain with a nonsteroidal antiinflammatory.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Plan for a follow-up echocardiogram occurring in 4 to 6 weeks: Follow-up echocardiograms are standard to monitor for coronary artery aneurysms, which may develop even after treatment. Early detection is vital to prevent long-term cardiac complications.

B. Resume the toddler's normal immunization schedule: Live vaccines such as MMR and varicella should be delayed for at least 10 months after IVIG, as the therapy can interfere with vaccine efficacy. Non-live vaccines may proceed as scheduled.

C. Irritability and tinnitus are expected for up to 2 weeks: Irritability is common, but tinnitus is not a recognized symptom of Kawasaki disease or its treatment. Persistent symptoms should be reported rather than assumed to be expected.

D. Manage joint pain with a nonsteroidal antiinflammatory: Aspirin, not general NSAIDs, is typically used for inflammation and thrombosis prevention in Kawasaki disease. Use of other NSAIDs may interfere with aspirin’s antiplatelet effects.

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Correct Answer is D

Explanation

Rationale:
A. Decreased urinary output: While decreased output may signal fluid imbalance or poor perfusion, it is not as immediately life-threatening as a cardiac arrhythmia. It should be monitored, but other findings take precedence in an acute setting.

B. Profound weight gain: Rapid weight gain suggests fluid retention, possibly from corticosteroid imbalance, but it does not pose an immediate danger compared to cardiac instability. It requires intervention but is not emergent.

C. Low blood glucose levels: Hypoglycemia is common after adrenalectomy due to cortisol deficiency and must be treated, but symptoms often develop gradually and are managed with glucose replacement. It is serious but not as acutely life-threatening as arrhythmias.

D. Ventricular arrhythmias: This finding indicates severe electrolyte disturbances—especially hyperkalemia, which can occur after adrenalectomy due to aldosterone deficiency. It poses an immediate threat to cardiac function and requires urgent intervention.

A. Lentils. B. Tea. C. Whole grain breads. D. Potato soup. E. Cheese.

Correct Answer is ["B","D"]

Explanation

Rationale:

A. Lentils: Lentils are high in fiber and are not part of a full liquid diet because they require chewing and contain residue. They are appropriate for a soft or regular diet, not a full liquid one.

B. Tea: Tea is a clear liquid and is included in a full liquid diet. It requires no chewing and leaves no residue, making it suitable postoperatively.

C. Whole grain breads: Breads are solid foods and not permitted on a full liquid diet. They require chewing and do not meet the consistency guidelines for this diet type.

D. Potato soup: Smooth, blended soups like potato soup are appropriate for a full liquid diet as long as there are no chunks. They provide calories and are easy to swallow.

E. Cheese: Cheese is a solid food and is not permitted on a full liquid diet.

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Body system	Findings
Cardiovascular	Blood pressure of 120/74 mm Hg Capillary refill of 4 seconds in lower extremities Pedal pulse of 2+ or better
Neurovascular	Pupils equal and nonresponsive to light Absence of numbness or tingling in feet Skin that is pale, cool to touch
Renal Perfusion	Client has urine output of 1,600 mL in 24 hours Creatinine of 1.2 mg/dL (106 mmol/L)

The nurse caring for a toddler with Kawasaki disease who is receiving intravenous immunoglobulin for severe coronary inflammation is planning discharge teaching for the parents. Which instruction should the nurse provide during the discharge education?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a history of a bilateral adrenalectomy is admitted with a weak, irregular pulse, and hypotension. Which assessment finding warrants immediate intervention by the nurse?

Correct Answer is D

Explanation

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Correct Answer is ["B","D"]

Explanation

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