The nurse is caring for a child with suspected Reye syndrome.
Which symptom is most concerning?
Projectile vomiting and confusion.
Fever and cough.
Mild headache.
Muscle aches.
The Correct Answer is A
Choice A rationale
Projectile vomiting and confusion are highly concerning symptoms in a child with suspected Reye syndrome. Projectile vomiting indicates increased intracranial pressure, and confusion reflects encephalopathy, both of which are hallmark signs of the severe neurological involvement in Reye syndrome.
Choice B rationale
Fever and cough are common symptoms of many childhood illnesses, particularly respiratory infections. While Reye syndrome can sometimes follow a viral illness, fever and cough alone are not specific indicators of this condition.
Choice C rationale
Mild headache is a relatively non-specific symptom and can be associated with various conditions. While headache may occur in the early stages of some illnesses, it is not the most concerning symptom suggestive of Reye syndrome.
Choice D rationale
Muscle aches can be associated with viral infections, which sometimes precede Reye syndrome. However, muscle aches alone are not as concerning as the neurological symptoms of confusion and increased intracranial pressure indicated by projectile vomiting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Limiting fluid intake is generally not indicated for atopic dermatitis unless there is a specific comorbid condition warranting fluid restriction. Maintaining adequate hydration is usually encouraged for overall skin health.
Choice B rationale
Promoting peeling of dead skin is not a primary goal in managing atopic dermatitis. The focus is on reducing inflammation, relieving itching, and maintaining skin hydration and barrier function, not necessarily on exfoliation.
Choice C rationale
Maintaining skin integrity and preventing infection are the most important goals in the care of a child with atopic dermatitis. The chronic inflammation and itching can lead to skin breakdown, increasing the risk of secondary bacterial or viral infections. Nursing interventions focus on gentle skin care, emollients, and managing itching.
Choice D rationale
Alcohol-based lotions should be avoided in children with atopic dermatitis as alcohol can dry and irritate the skin, exacerbating the condition and impairing skin integrity. Emollients that are fragrance-free and hypoallergenic are preferred to maintain skin hydration.
Correct Answer is A
Explanation
Choice A rationale
Urinary tract infections can cause bladder irritation and dysfunction, leading to symptoms such as frequency, urgency, and nocturia, which can manifest as enuresis, especially secondary enuresis (bedwetting that starts after a period of dryness). Therefore, assessing for a UTI is a crucial first step to rule out a treatable medical cause. Normal urine specific gravity ranges from 1.005 to 1.030, and a urinalysis can detect the presence of bacteria, white blood cells, or nitrites indicative of infection.
Choice B rationale
Psychological stressors can contribute to enuresis, particularly secondary enuresis. Anxiety, family changes, or school-related stress can manifest physically. While important to explore, medical causes like UTIs should be ruled out first.
Choice C rationale
Sleep patterns are relevant in the context of enuresis, as bedwetting occurs during sleep. However, assessing for a medical cause like a UTI should precede a detailed evaluation of sleep habits.
Choice D rationale
A family history of enuresis can suggest a genetic predisposition. However, the immediate nursing priority is to assess for and rule out treatable underlying medical conditions, such as a urinary tract infection.
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