The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction?

Coughing spells may be triggered by dust or smoke."

We need to maintain droplet precautions and a quiet environment for at least 2 weeks.

"We need to encourage our child to drink fluids.

Vomiting may occur when our child has coughing episodes."

Answer and Explanation

The Correct Answer is B

A. Coughing spells may be triggered by dust or smoke:
Incorrect: This is a correct statement. Irritants like dust or smoke can trigger coughing spells in a child recovering from pertussis.
B. We need to maintain droplet precautions and a quiet environment for at least 2 weeks.
Correct Answer: Pertussis is highly contagious during the catarrhal and paroxysmal stages, but once the child has reached the convalescent stage (usually after 2-4 weeks of illness), the risk of spreading the infection decreases significantly. Continuing strict droplet precautions and a quiet environment for two weeks after the convalescent stage is not necessary.
C. "We need to encourage our child to drink fluids":
Incorrect: This is a correct statement. Encouraging fluid intake is important to prevent dehydration, especially during coughing spells.
D. Vomiting may occur when our child has coughing episodes:
Incorrect: This is a correct statement. Vomiting can be a common occurrence during coughing episodes in pertussis due to the forceful nature of the cough. Parents should be aware of this symptom.

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Correct Answer is D

Explanation

A. Sausage-shaped mass palpated in the upper right abdominal quadrant.
Explanation: A sausage-shaped mass in the upper right abdominal quadrant is more indicative of Hirschsprung's disease, not imperforate anus. In Hirschsprung's disease, there is a lack of ganglion cells in the rectum, leading to obstruction and a palpable mass.
B. The passage of currant jelly-like stools.
Explanation: The passage of currant jelly-like stools is characteristic of intussusception, a condition where one portion of the intestine telescopes into another. It is not associated with imperforate anus.
C. Bile-stained fecal emesis.
Explanation: Bile-stained fecal emesis suggests a possible intestinal obstruction or other gastrointestinal issue, but it is not a specific manifestation of imperforate anus. Imperforate anus is primarily characterized by the absence of a normal anal opening.
D. Failure to pass meconium stool in the first 24 hours after birth.
Explanation:
Imperforate anus refers to a congenital condition in which the opening to the anus is absent or improperly formed. One of the clinical manifestations is the failure to pass meconium stool within the first 24 hours after birth. Meconium is the thick, sticky, greenish-black substance that constitutes a newborn's first stools. The absence of meconium passage suggests a potential obstruction.

A. "Range-of-motion exercises must be performed every day." B. "Administer additional pain medication before performing range-of-motion exercises." C. "Have the child perform simple isometric exercises during this time." D. "Avoid all exercise during painful periods."

Correct Answer is C

Explanation

A. "Range-of-motion exercises must be performed every day."
Explanation: While range-of-motion exercises are important for maintaining joint flexibility in juvenile idiopathic arthritis, it is not advisable to perform these exercises during painful exacerbations. The frequency and intensity of exercises may need to be adjusted based on the child's current condition.
B. "Administer additional pain medication before performing range-of-motion exercises."
Explanation: While pain management is important in the care of a child with juvenile idiopathic arthritis, relying solely on pain medication before exercises may not be the most effective approach. Isometric exercises that are less likely to cause pain can be a better option during exacerbations.
C. "Have the child perform simple isometric exercises during this time."
Explanation:
During a painful exacerbation of juvenile idiopathic arthritis, it is important to maintain joint flexibility and prevent joint contractures. Simple isometric exercises that do not involve joint movement can help in maintaining muscle strength and joint flexibility without exacerbating pain. Range-of-motion exercises may be too painful during an exacerbation, but isometric exercises can be less painful and still beneficial.
D. "Avoid all exercise during painful periods."
Explanation: Complete avoidance of exercise during painful periods is not recommended. Maintaining joint flexibility and muscle strength is important for managing juvenile idiopathic arthritis. However, the type and intensity of exercises should be adjusted based on the child's pain level during exacerbations.

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The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder?

Correct Answer is D

Explanation

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse would make which response?

Correct Answer is C

Explanation

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