A 7-year-old child has been diagnosed with rheumatic fever. Which of the following physical findings would the nurse expect to assess?

Correct Answer: B

Rationale: Rheumatic fever is an inflammatory condition that can affect different parts of the body, including the joints. The typical physical finding in a child with rheumatic fever is warm and swollen joints, especially in the knees and elbows. This is known as migratory arthritis and is one of the major criteria in the Jones criteria for diagnosing rheumatic fever. Other major criteria include carditis, subcutaneous nodules, erythema marginatum, and Sydenham chorea. So, in a 7-year-old child diagnosed with rheumatic fever, the nurse would expect to assess warm and swollen joints as part of the physical examination.

Correct Answer: D

Rationale: The most common symptom of Juvenile Rheumatoid Arthritis (JRA) that causes a patient to seek medical attention is pain. Joint pain is a hallmark symptom of JRA and can range from mild discomfort to severe pain. This pain can be persistent or intermittent, and it often worsens with movement or activity. Pain is a significant factor that leads patients to seek medical evaluation in order to diagnose and manage their condition. While joint swelling, limited movement, and fatigue are also common symptoms of JRA, pain is typically the primary reason patients seek medical attention.

Correct Answer: B

Rationale: Hemophilia is an X-linked recessive disorder where the genes responsible for blood clotting factors are located on the X chromosome. This disorder primarily affects males, as they have only one X chromosome. Females are carriers and can pass the gene on to their sons. Hemophilia results in prolonged bleeding episodes as the blood is unable to clot properly. Thalassemia, leukemia, and sickle cell anemia are not X-linked disorders. Digoxin is a medication used for heart conditions, not related to X-linked disorders.

Correct Answer: B

Rationale: While a child with nephrotic syndrome is confined to bed, changing their position frequently is an appropriate nursing intervention to prevent complications associated with immobility. Constant pressure on certain areas of the body can lead to skin breakdown, discomfort, and decreased circulation which can exacerbate the child's condition. Changing positions frequently helps prevent these complications and promotes circulation and comfort. Restraints should only be used when necessary for the safety of the child or others, passive rang-of-motion exercises should be done more frequently than once a day to prevent contractures, and discouraging parents from holding their child can have negative emotional and psychological effects on the child's well-being.

Correct Answer: C

Rationale: The newborn's posture at rest and arm recoil are two physical signs used to determine gestational age. Assessment of posture at rest involves observing the newborn's flexed or extended posture when lying flat on their back. Premature infants tend to have more flexed postures due to their immature muscular tone. Arm recoil refers to the ability of the newborn to return their extended arm flexes to the flexed position. This reflex is typically present in more mature infants. These physical signs, along with other factors such as skin texture, breast development, and ear formation, are used by healthcare providers to estimate the gestational age of newborns. While length, weight, and head circumference are also important measurements, the posture at rest and arm recoil are specifically used in determining gestational age.